Blue Shield of CA
Provider Contracting Specialist, Consultant
Blue Shield of CA, Oakland, California, United States, 94616
Your Role
The Network Management team is responsible for the development and maintenance of all provider networks, including vendor and Plan to Plan relationships 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.
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 principles 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.
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