Your Role
The Model Contracts team manages and maintains Blue Shield of California’s standardized provider agreement templates across multiple lines of business and risk arrangements. The Provider Contracting Specialist, Senior (Model Contracts) will report to the leader of the Model Contracts team. In this role, the individual will support the accuracy, consistency, and regulatory compliance of provider contract templates, enabling compliant and efficient provider contracting operations across the organization.
Our leadership model is about developing great contributors at all levels and creating opportunities for our people to grow personally, professionally, and financially. We are looking for professionals who are energized by analytical thinking, collaboration, attention to detail, and sustaining high-quality work through continuous improvement
Your Work
In this role, you will:
Maintain and update standardized provider contract templates used across Blue Shield of California
Support contract templates covering multiple risk arrangements and product types, including shared, dual, and full risk; facility and medical group agreements; IPPA; and HMO and PPO products
Coordinate cross-functional reviews of contract template updates with Legal, Mandate teams, and internal subject matter experts
Incorporate legal, regulatory, and mandate-driven changes into approved template language
Prepare and manage governmental filings for new or updated provider contract templates and track approval status
Maintain accurate version control, documentation, and approval records for all model contract templates
Serve as a resource to Provider Contracting and related teams regarding approved template language and appropriate usage
Identify potential compliance risks or inconsistencies and escalate through established governance channels
Support internal audit, compliance, and regulatory review requests related to provider contract templates
Your Knowledge and Experience
Bachelor’s degree in Business, Healthcare Administration, Healthcare Policy, Public Health, or a related field, or equivalent experience
Minimum of 5 years of relevant experience in healthcare contracting, contract administration, regulatory support, or a related role involving standardized agreement maintenance
Knowledge of healthcare provider contracting concepts and managed care products
Experience coordinating reviews with legal, regulatory, and business stakeholders
Strong written and verbal communication skills with high attention to detail
Strong organizational, prioritization, and documentation skills
Proficiency with Microsoft Office applications; experience with contract management systems preferred
Hybrid
This role requires employees to be in-office based on our hybrid workplace model, balancing purposeful in-person collaboration with flexibility. For most teams, this means coming into the office two days each week.
Employees living more than 50 miles from an office location will work with their manager to determine in-office time based on business need.
Blue Shield of California strives to create a healthcare system worthy of its family and friends that is sustainably affordable. The health plan is a tax paying, nonprofit, independent member of the Blue Shield Association with nearly 6 million members, over 7,500 employees and more than $25 billion in annual revenue.
Founded in 1939 in San Francisco and now headquartered in Oakland, Blue Shield of California and its affiliates provide health, dental, vision, Medicaid and Medicare healthcare service plans in California. The company has contributed more than $60 million to Blue Shield of California Foundation in the last three years to have an impact on California communities.
For more news about Blue Shield of California, please visit news.blueshieldca.com.
