Contract Manager - Ancillary

Point32Health • Canton, MA

3d • $85,277 - $127,916 • Hybrid

About The Position

Under the direction of the Point32Health Manager, Allied Health Contracting, the Contract Manager, Allied Health Contracting negotiates and manages contracts with ancillary service providers and network vendors with particularly complex provider and/or reimbursement issues. Key activities include determination of network needs, evaluation of prospective providers, development of reimbursement strategies, and contract negotiation and administration. The Contract Manager must maintain industry-specific knowledge and relationships with key providers and industry groups. This individual serves as a mentor and resource to Associate Contract Managers on the team and may supervise 1-3 Associate Contract Managers.

Requirements

• Bachelors degree in a related field
• minimum 5-7 years of professional experience
• Effective communication and presentation skills, both verbally and in writing
• High degree of initiative and result-orientation, and ability to deal effectively with ambiguous situations
• Proven time management and organizational skills, and ability to work independently and prioritize multiple demands
• Ability to understand the nuances of Tufts Health Plan’s commercial and Medicare Preferred product lines and the unique operational and financial features associated with each
• Ability to lead and motivate others by fostering an attitude of cooperation and commitment, as well as capacity of liaison and negotiator
• Strong financial/analytical skills and problem-solving ability, with the ability to research, interpret, and communicate complex issues
• High degree of professionalism and confidence, including the ability to recognize politically sensitive issues, utilize diplomacy, and interact effectively with all levels of personnel
• Excellent computer skills, including proficiency in Microsoft Word, PowerPoint, and Excel

Nice To Haves

• Master’s degree
• Experience in a managed health care environment, with a thorough knowledge of the health care market and the needs/concerns of health care providers
• Contract negotiation experience is desirable, with ability to understand and interpret all aspects of a contract: financial, legal, and operational with emphasis on implementation of contract terms

Responsibilities

• Develops, negotiates, executes and manages provider contracts for services with complex provider and/or reimbursement issues.
• Participates in all operational aspects of contractual agreements.
• Develops and maintains key provider relationships.
• Collaborates with analytic staff to develop medical budget, evaluate cost trends, and formulate reimbursement models and/or program design.
• Monitors marketplace trends and new reimbursement methodologies.
• Evaluates the demand for assigned services and identifies areas of network deficiencies or increased service demand for network expansion.
• Determines the unique service capabilities of providers in the network.
• Designs and implements tools for communicating these capabilities to other departments and membership.
• Identifies, evaluates, and implements new programs for improving medical cost management and/or administrative efficiency.
• Represents Allied Health Services in internal and external meetings.
• Prepares and delivers presentations to partner departments and industry forums.
• Serves as mentor and resource to Associate Contract Managers on team.
• May be required to directly supervise 1-3 Associate Contract Managers.
• Other duties and projects as assigned.

Benefits

• Medical, dental and vision coverage
• Retirement plans
• Paid time off
• Employer-paid life and disability insurance with additional buy-up coverage options
• Tuition program
• Well-being benefits
• Full suite of benefits to support career development, individual & family health, and financial health

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level