Work in Iowa Disability Jobs

Job Information

BLUE CROSS BLUE SHIELD OF NEBRASKA Director Provider Contracting in COUNCIL BLUFFS, Iowa

Job no: 495175Blue Cross and Blue Shield of Nebraska (BCBSNE) is more than just an insurance company; we exist to be there for people in the best and hardest moments of their lives.Our team is the power behind that promise. And, as the industry rapidly evolves and we seek ways to optimize business processes and customer experiences, there's no greater time for forward-thinking professionals like you to join us in delivering on it!As a member of Team Blue, you'll find purpose, opportunities and the support you need to build a meaningful career and make a powerful impact in our community.As the Manager of Provider Contracts you will be responsible for preparing provider contract templates for use with PPO and other network providers. You will pursue executed contracts with health care providers and participation in the strategic administration of the provider networks and related reimbursement of participating providers. You will also be responsible for negotiating and executing case specific out-of-network exceptions for BCBSNE members who utilize providers who are not participating in a Blue Cross Blue Shield provider network. You will also work with the Legal Department in resolving contractual questions and issues posed by participating network providers.Essential Duties and Responsibilities: Contact and negotiate out-of-network exceptions with out-of-network providers utilized by BCBSNE members.Respond to provider contract questions and requests for revision of contract language.Create, implement and edit provider contracts templates.Memorialize results of provider negotiations in provider agreements, addendums and attachments.Negotiate with providers to enhance availability of health care services for BCBSNE members and support new products included in provider networks.Participate in determining methodologies used to reimburse network providers.Work with Legal Department to respond to provider contract issues and complaints.Assist department leadership in strategic planning and resolving issues during key provider negotiations.Must meet or exceed the attendance and timeliness requirements of their departments.Must work well in a team environment, and be capable of building and maintaining positive relationships with other staff, departments, and customers.In order to be considered, candidates must possess: Bachelor's degree.5 years of provider contracting and provider network administration experience.Management Experience.Budget experience.Working knowledge of provider contracts and experience with contract negotiation.Excellent oral, written and interpersonal communication skills.Ability to work independently or collaborate with teams towards meeting provider network goals.Ability to organize and manage multiple priorities and high volumes of questions on a daily basis.Strong analytical and problem-solving skills.Working knowledge of Microsoft Word and Excel.Strongest Candidates will possess:10+ years of provider contracting and provider network administration experienceLearn more about what makes BCBSNE such an exceptional place to work by visiting NebraskaBlue.com/Careers.We strongly believe that diversity of experience, perspective and background will lead to a better workplace for our employees and a better product for our customers and members. Blue Cross and Blue Shield of Nebraska is an Equal Opportunity/Affirmative Action Employer - Minorities/Females/Disabled/Veterans

DirectEmployers