Your Role

The Network Management team is responsible for the development and maintenance of all provider networks, including vendor and Plan to Plan relationship necessary to provide our members and clients with access to quality, affordable health care services. The Provider Contracting Specialist, Consultant will report to the Program Manager, Principal. This role will support Blue Shield of California's Behavioral Health including Applied Behavioral Analysis (ABA) and selective Ancillary programs including supporting Plan to Plan, and vendor operations.

Your Knowledge and Experience

• Requires a college degree in Business, Healthcare Policy, Public Health, or related field, or equivalent experience
• Requires 7 years of prior relevant experience
• Requires Behavioral Health Provider contracting experience
• A minimum of 3 years of experience in Behavioral Health managed care and Behavioral Health Provider Contracting/Negotiation, including experience managing ABA complex negotiation is preferred
• Experience in handling Letters of Agreements with Behavioral Health Providers, ABA and Telehealth Groups
• Thorough knowledge of the principals of provider relations and operations of Managed Care Commercial, Medicare, and Medi-Cal contracting
• Knowledge of Behavioral Health appeals and grievances

Pay Range:

The pay range for this role is: $109,340.00 to $164,120.00 for California.

Note:

Please note that this range represents the pay range for this and many other positions at Blue Shield that fall into this pay grade. Blue Shield salaries are based on a variety of factors, including the candidate's experience, location (California, Bay area, or outside California), and current employee salaries for similar roles.

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