Independence Blue Cross · 1 week ago
Provider Network Contract Manager (Behavioral Health) - Hybrid (PA/NJ/DE)
Philadelphia, Pennsylvania
Full-time
Hybrid
Senior Level
5+ years expIndependence Blue Cross is focused on enhancing the health and well-being of the communities they serve. They are seeking a Provider Network Contract Manager to manage behavioral health contracts and lead negotiations with network providers, ensuring compliance with business goals and effective contract management.
Health CareHealth InsuranceInsuranceMedical
Responsibilities
Responsible for management of behavioral health contracts, including contract negotiations and ongoing management of contracting issues
Leads negotiations with network providers, including responsibility for the end-to-end management of provider negotiations and ongoing contract management
In conjunction with leadership, develops negotiation strategies based on assessment of baseline analytics, financial targets, contractual terms, Independence strategic objectives and industry trends
Ensures provider contracting is consistent with claim payment methodologies
Accountable for ongoing management of an assigned contract portfolio including assessment and resolution of issues, contract performance, monitoring unit-cost budgeting, and ongoing provider engagement
Ensures that non-standard contract elements are communicated to appropriate departments and obtains Plan approval prior to submission to provider
To ensure contract terms are administered correctly, contract requirements are communicated timely and accurately to internal stakeholders and operational areas throughout term of each contract
Coordinates with internal stakeholders (e.g. Care Management, Legal, Operations) to ensure identified issues are incorporated into negotiation objectives
Works closely with network services team to ensure servicing issues are being resolved in accordance with contractual terms
Communicates negotiation status to Director and senior leadership throughout process
Assists in the development of FHN strategies, reimbursement methodologies and processes
Builds and maintains positive relationships with counterparts in the Provider community
Performs other duties as assigned
Qualification
Required
Bachelor's degree in business or health related discipline such as Healthcare Administration or Healthcare Management
Minimum of 5 years provider contracting/reimbursement experience in healthcare setting
Experience with Behavioral Health Providers
Excellent written and oral communication
Ability to demonstrate a high level of attention to detail
Experience with building relationships among key stakeholders
Able to occasionally travel to provider sites
Preferred
Master's Degree
Company
Independence Blue Cross
The leading health insurer in southeastern Pennsylvania. It is a sub-organization of Independence Blue Cross.
5001-10000 employees
Funding
Current Stage
Late StageLeadership Team
Alexandra Jorgensen
Senior Vice President Human Resources
Joe Geist
SVP & Market President, National
Recent News
Home Health Care News
2026-01-14
Company data provided by crunchbase