Manager, Provider Contracting

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.

United States, MI

Blue Cross Blue Shield of Michigan

When you think of <a href="https://www.bcbsm.com/" 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.&nbsp;<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="http://www.bcbsm.com/index/about-us/our-company.html" 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 />For Application Timeline &amp; Selection Process:&nbsp;<a href="https://s3.amazonaws.com/data.vizirecruiter.com/Images/BCBSMCareers+-+Quick+Reference+Guide.pdf" target="_blank" rel="noopener noreferrer">Click Here</a>. Learn more about your options as an external candidate. <a href="https://ejko.fa.us2.oraclecloud.com/hcmUI/CandidateExperience/en/sites/CX_3/requisitions" target="_blank" title="BCBSM" rel="noopener noreferrer">Click here</a> to view open positions. http://www.bcbsm.com

keywords: position summary,department summary,management,quality assurance,department preferences,education,experience,skills,knowledge

Mid-level Manager

Competitive Total Compensation Package

Overview: <strong>Responsible for planning, organizing and managing an assigned business unit.&nbsp; Operate within broad objectives to ensure optimum utilization of resources; adapt business unit plans and priorities to address resource and operational challenges. Evaluate policies, procedures and business unit goals to make decisions and solve problems.<br /><br /></strong>Department Summary<strong><br /><br /></strong>Responsible for negotiation and implementation of professional provider agreements, including contracts with Risk-Bearing Contracted Entities (RBCEs) and Medical Care Groups (MCGs). Oversees provider contracting and contract maintenance. Participates in the development of provider contracting and network development strategy and planning. &nbsp;<strong><br /></strong>
Responsibilities: <ul> <li>Manage activities of a department including, but not limited to planning, problem solving, staff development and communication.</li> <li>Manage the evaluation of new and existing business processes to identify areas of opportunity and execute on business unit objectives, supporting continuous improvement.</li> <li>Lead, direct, evaluate and develop the work of assigned employees.</li> <li>Responsible for special projects, programs and initiatives to ensure successful delivery of business outcomes.</li> <li>Provide effective and efficient solutions to complex business problems</li> <li>Ensure that day to day business unit operations align with organizational objectives.</li> </ul> <br />Department&nbsp;Preferences<br /> <ul> <li>Utilize data analytics and extensive business knowledge to manage the research, analysis, identification, and evaluation of provider financial and quality data. From there, identify and evaluate existing trends, potential issues, and solutions.</li> <li>Identify opportunities to improve contract pricing to reduce BCBSM/BCN benefit cost expense.</li> <li>Develop and maintain relationships with key external provider groups and individuals.</li> <li>Independently develop and plan reports, presentations, and/or other contracting materials.</li> </ul>
Requirements: <ul> <li>Bachelor's Degree in a related field is required.&nbsp; Master's Degree in a related field is preferred.&nbsp;</li> <li>Five (5) years of experience in a related field is required.</li> <li>Previous experience leading projects and/or teams is required.</li> <li>Ability to effectively lead, coach and develop team members.</li> <li>Ability to work effectively in a team environment.</li> <li>Strong organizational, planning, analytical, and problem-solving skills.</li> <li>Working knowledge of corporate organizational structures, including functional responsibilities.</li> <li>Strong verbal, written communication and interpersonal skills.</li> <li>Ability to manage multiple priorities concurrently.</li> <li>Ability to solve practical problems and deal with moving variables in situations with limited standardization and alignment.</li> <li>Ability to interface and present to all levels of the organization.&nbsp;&nbsp;</li> <li>Ability to build relationships and work collaboratively with cross-functional teams.</li> </ul>