Capital Blue Cross

Director, Network Contracting

Capital Blue Cross

full-time

Posted on:

Location Type: Hybrid

Location: Harrisburg • Pennsylvania • United States

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Salary

💰 $118,650 - $223,560 per year

Job Level

Lead

About the role

  • Lead all aspects of Capital’s network contracting activities related to traditional FFS and value-based reimbursement methodologies for the network portfolio; including facility, ancillary, and professional providers.
  • Responsible for direct oversight, management and training of the contracting staff reporting to this position.
  • Responsible for the negotiation of contract terms, unit cost management, and strategic network-inspired product designs - such as, tiered or narrow networks etc.
  • Lead the transformation of Capital’s existing network from a primarily fee-for-service driven model to a model to value based programs that align with the Triple Aim objectives (satisfaction, quality, and cost).
  • Provide leadership in evaluating opportunities to expand or change the network to meet company goals.

Requirements

  • A minimum of seven years of successful management experience in a health care related business, with a minimum of 5 years negotiating provider agreements.
  • 2-3 years’ contractual and/or operational experience with value based programs (ACO, PCMH, and bundled Payments) preferred.
  • Minimum requirements include a Bachelor’s Degree in a health related field. Master degree highly preferred.
Benefits
  • Medical, Dental & Vision coverage
  • Retirement Plan
  • Generous time off including Paid Time Off
  • Holidays
  • Volunteer time off
  • Incentive Plan
  • Tuition Reimbursement
Applicant Tracking System Keywords

Tip: use these terms in your resume and cover letter to boost ATS matches.

Hard Skills & Tools
negotiationcontract managementunit cost managementnetwork designvalue-based reimbursementfee-for-serviceprovider agreementscontractual experienceoperational experiencehealth care management
Soft Skills
leadershipmanagementtrainingstrategic thinkingevaluation
Certifications
Bachelor's DegreeMaster's Degree