Senior Director Network Contracting

Capital Blue Cross | Harrisburg, Pennsylvania 17110

Salary Range: Call for details
Date Posted: August 30, 2023
Opportunity Code: 33206


Capital Blue Cross is conducting a nationwide search for a Senior Director Networking Contracting to join their organization in Harrisburg, Pennsylvania. Reporting to Vice President of Value Based Contracting, the Senior Director will be accountable for oversight of all contracts related activities within the Healthcare Delivery enterprise, including strategic development, negotiation and implementation of new value-based agreements in addition to the alignment of legacy provider fee for service contracts in support of value-based agreements.

The Position: 

The Senior Director of Network Contracting, reporting to the Vice President of Provider Partnerships, is responsible for the oversight of all contract-related activities within the Healthcare Delivery enterprise, including strategic development, negotiation and implementation of new value-based agreements in addition to the alignment of legacy provider fee-for-service contracts in support of value-based agreements. 

The Senior Director of Network Contracting provides leadership to develop and deploy complex contracting activities through multiple reimbursement methodologies and to meet or exceed budgetary goals. The Senior Director maintains positive relationships with all external stakeholders to ensure key contracting objectives can be met. This leader ensures the negotiation of all key terms of contractual arrangements within key timeframes required to maintain contractual relationship. The Senior Director meets with providers regularly to understand evolving business models, support escalation efforts, and share comparative analysis and has responsibility for the development and application of the healthcare strategy for the organization and will ensure medical input and direction to all areas where clinical leadership and medical expertise is required. This leader must possess exceptional leadership skills and transformational experience with a proven track record of delivering results. 

The Ideal Candidate: 

  • Minimum of five years of successful management experience in a health plan or large health system setting along with seven years of negotiating provider agreements.
  • Extensive experience developing, negotiating, and managing risk based (ACO, MLR, Partial and Global Risk) agreements required.
  • Knowledge of current and emerging reimbursement and alternate payment models, to include governmental reimbursement methodologies.
  • Knowledgeable of various State and Federal licensing requirements and bodies; and existing accreditation organizations (Joint Commission, CARF, etc.).
  • Strong knowledge of value-based payment methodology required.
  • Bachelor’s Degree required. Master’s Degree highly preferred.

The Organization:

Capital Blue Cross serves a 21-county region in Central Pennsylvania and the Lehigh Valley by offering health insurance products, services and technology solutions that provide peace of mind and promote health and wellness for our members. We focus on simplifying and personalizing the healthcare experience and using innovative solutions – including patient-focused care models, actionable data, and digital health technologies – to create healthier lives and lower healthcare costs. Our Capital Blue Cross Connect health and wellness centers provide in-person service and inspiration to help people reach their health goals. Capital Blue Cross is an independent licensee of the Blue Cross Blue Shield Association. Capital Blue Cross was recently recognized as one of the “Best Places to Work in Pennsylvania” for the fifth straight year and has been honored with national awards.

Capital Blue Cross employs approximately 2,000 employees and serves 838,000 covered lives. Headquartered in Harrisburg as an independent licensee of the BlueCross BlueShield Association, Capital Blue Cross serves central Pennsylvania and provides healthcare coverage and products to many nationally known companies. The company also operates several Capital Blue Cross Connect health and wellness centers across our service region that offer health plan consultations, fitness classes, health and nutrition coaching, and other personalized services to the general public. 

The Location:

Harrisburg, situated on the east bank of the Susquehanna River, is the capital city of the Commonwealth of Pennsylvania and the larger principal city of the Harrisburg–Carlisle metropolitan statistical area, also known as the Susquehanna Valley. With a population of 591,712 as of 2020, the Susquehanna Valley is the fourth most populous metropolitan area in Pennsylvania after the Philadelphia, Pittsburgh, and Lehigh Valley metropolitan areas. The Hershey Harrisburg Region is a Mid-Atlantic destination hub within a three-hour drive of major East Coast destinations, including New York, Philadelphia, New Jersey, Washington D.C., Baltimore, and Pittsburgh. The Hershey Harrisburg Region is made up of charming small towns, vibrant communities, and unique neighborhoods that create a rich and robust must-see destination. Connections to neighboring destinations are made easy with a sprawling Interstate system, rail lines and the convenience of Harrisburg International Airport.

Please direct all inquiries, applications, and referrals to: 

Mick Ruel, Vice President

Rachael Burns, Vice President

Heather Van Hecke, Consultant

AMN Leadership Solutions, Executive and Physician Leadership Search

AMN Leadership Solutions, Executive and Physician Leadership Search, is a retained executive search firm serving the healthcare and life sciences industries. Ranked as one of the top healthcare recruiting firms in the country, AMN Leadership Solutions is known for leading healthcare into the future by its growing base of clients across the country, drawing on a national pool of candidates.




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