Manager - Financial Analysis and Contracting-Grand Rapids-BCN

With more than 7,000 employees, we are the largest health insurance company in Michigan. We offer an exciting work environment with a diverse group of employees. Our goal is to make health insurance easier for our members. We want to transform the industry and become a resource that people can trust.

Grand Rapids, MI

Blue Cross Blue Shield of Michigan

When you think of <a href="" target="_blank" rel="noopener noreferrer">Blue Cross Blue Shield of Michigan</a> for health insurance, you can know you&rsquo;re getting much more. We're a company founded on a tradition of affordable, quality health care for everyone, improving the present and investing in the future.<br /><br />We offer:<br />Plans for employers and individuals that meet today&rsquo;s needs, budgets and lifestyle<br />The largest network of doctors and hospitals in the state<br />Lower health care costs Higher quality health care<br />Award-winning diversity practices<br />Grants and programs that promote better health throughout Michigan<br /><strong><br />Mission:&nbsp;</strong>We commit to being our members&rsquo; trusted partner by providing affordable, innovative products that improve their care and health.<br /><br /><a href="" target="_blank" rel="noopener noreferrer"><strong>Click here</strong></a> to learn more about our commitment to our Social Mission, view company updates and reviews, and view our awards &amp; accolades.<br /><br />Learn more about your options as an external candidate. <a href="" target="_blank" rel="noopener noreferrer">Click here</a> to view open positions.

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Competitive Compensation and Benefits Package

Overview: <p><span style="font-family: Arial;">This position is responsible for negotiation and implementation of provider agreements, including professional, ancillary and facility agreements. Oversees regional provider contracting and contract maintenance. Participates in the development of provider contracting and network development strategy and planning, along with regional and corporate staff.<br /></span></p> <div><span style="font-size: small;"><strong>DEPARTMENT REQUIREMENTS:</strong>&nbsp;</span></div> <div> <ul type="disc"> <li><span style="font-family: Arial; font-size: small;">Demonstrated ability to prepare analytical reports and presentations to management, provider groups, and other stakeholders.</span></li> <li><span style="font-family: Arial; font-size: small;">Demonstrated ability to drive engagement of the Analyst team.</span></li> <li><span style="font-family: Arial; font-size: small;">Excellent verbal and written communication skills.</span></li> <li><span style="font-family: Arial; font-size: small;">Excellent presentation skills to internal and external management, provider groups, and other stakeholders.</span></li> <li><span style="font-family: Arial; font-size: small;">Must have a valid, non-restricted drivers license.</span></li> <li><span style="font-family: Arial; font-size: small;">Statewide travel required at approximately 30%.</span></li> </ul> </div> <p><span style="font-family: Arial;">&nbsp;</span></p>
Responsibilities: <ul> <li> <div><span style="font-family: Arial;">Oversees regional provider contracting and contract maintenance.</span></div> </li> <li><span style="font-family: Arial;">Participates in the development of contract strategy and network development with regional and corporate staff.&nbsp;</span></li> <li><span style="font-family: Arial; font-size: small;">Identifies opportunities to improve contract pricing to reduce BCBSM/BCN benefit cost expense.</span></li> <li><span style="font-family: Arial; font-size: small;">Identifies poor performing providers and provides recommendations for improvement.</span></li> <li><span style="font-size: small;"><span style="font-family: Arial;">Responsible&nbsp;for negotiation and implementation of professional, ancillary, and facility agreements.</span></span></li> <li><span style="font-family: Arial; font-size: small;">Administers labor agreements and appropriate problem resolution including grievance handling.</span></li> <li><span style="font-size: small;"><span style="font-size: small;"><span style="font-family: Arial;">Interviews and makes hiring and transfer recommendation/decisions in regard to staff for the department.&nbsp;</span></span></span></li> <li><span style="font-size: small;"><span style="font-size: small;"><span style="font-family: Arial;">Conducts performance evaluations, counsels, coaches, and administers discipline.</span></span></span></li> <li><span style="font-family: Arial; font-size: small;">Responsible for ensuring staff training and development.</span></li> <li><span style="font-family: Arial; font-size: small;">Keeps abreast of changes in corporate policies and procedures, and communicates changes with staff as appropriate.</span></li> <li><span style="font-size: small;"><span style="font-family: Arial; font-size: small;">Develops and/or assists in budget preparation and adheres to budget.</span></span></li> <li><span style="font-family: Arial;">Other duties may be assigned.</span></li> </ul>
Requirements: <ul> <li><span style="font-size: small;">Bachelor degree in business, healthcare or related field required.</span></li> <li><span style="font-size: small;">Three (3) years experience in a health care environment which can be a combination of demonstrated and successful experience in the following areas</span></li> <ul> <li><span style="font-size: small;">Provider contracting</span></li> <li><span style="font-size: small;">Provider reimbursement</span></li> <li><span style="font-size: small;">Provider financial analysis</span></li> </ul> <li> <p><span style="font-size: small;">Two (2) years of supervisory experience required (if position has direct reports).&nbsp;</span></p> </li> <li> <p><span style="font-size: small;">Two (2) years of lead/supervisory experience required (if position does not have direct reports).</span></p> </li> <li> <p><span style="font-size: small;">Knowledge of managed care principles, benefit design, claims processing, computer systems, finance, data reporting and design, and statistical analysis required.</span></p> </li> <li> <p><span style="font-size: small;">Familiarity with FACETS, MACESS, and Business Objects reporting preferred. Responsible for ensuring staff training and development.&nbsp;</span></p> </li> </ul>