Posted in Other 30+ days ago.
Location: WOODLAND HILLS, California
Job Summary
The Provider Contracting Specialist, Consultant - Network Manager Ancillary and Specialty Network position is focused on negotiating agreements with a variety of Ancillary Provider Types including clinical laboratories, Home Infusion/ Specialty Pharmacies, and Home/Durable medical Equipment providers. In addition, this position is responsible for driving strategies to reduce the Cost of Healthcare, improve quality outcomes, and broaden our networks to include Medi Cal, Medicare, and BSC Tandem/ High Performing Networks Lines of Business throughout the state of California. The Contract Specialists Consultant positions also play major roles in our Network Strategy to transform reimbursement methodologies to value based reimbursement methodologies . This Contract Specialist ,Consultant positions will also function as Subject Matter Experts on the networks the positions are responsible for, supporting other Blue Shield of Ca depts such as Legal, medical and Provider Operation, etc.
The Provider Contracting Specialist, Consultants will be members of a high performing team responsible for assigned regional service area in managing & maintaining California's largest PPO physician network, to support our 4.6 million HMO and PPO members with over $2.0 billion in annual spend.
Responsibilities
Knowledge & Experience
Additional Information
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