Director, Contracting

Point32Health • Canton, MA

6d • $160,271 - $240,407

About The Position

The Director of Contracting is responsible for contract strategy, development, negotiation, and implementation for hospitals, physician groups, and integrated delivery systems across multiple markets and products. The Director leads a team negotiating contracts, including risk arrangements, to build high-performing provider networks that support membership growth, quality, and financial performance. The role also fosters strong relationships with strategic providers to advance shared plan and provider objectives.

As a member of the leadership team, the Director participates in division strategy, planning, and performance initiatives. The role manages contract managers and works in a matrix environment with functions including risk adjustment, population health, finance, operations, actuarial, and sales.

Requirements

• Bachelor’s degree in business, health care, or a related field.
• 10–15 years of progressively responsible management experience in a complex healthcare setting.
• Experience in managed care contracting and collaborative work with providers.
• Strong working knowledge of managed care and risk-contracting payment methodologies.
• Negotiation experience across provider payment methodologies, including risk, with a demonstrated ability to close agreements while maintaining relationships.
• Excellent quantitative skills, including the ability to synthesize financial information and create and evaluate options.
• Excellent interpersonal skills and diplomacy to anticipate, recognize, and address complex issues.
• Strong relationship skills to influence and collaborate with physicians and other provider leaders.
• Management skills to guide, inspire, and develop a high-performing team.
• Ability to manage multiple priorities across markets while meeting aggressive deadlines.
• Adaptability in changing or ambiguous situations, constructive behavior in challenging situations, strategic thinking and planning, and ability to assess enterprise and provider interests.
• Ability to collaborate effectively across functions.
• Ability to work under normal office conditions and from home as required.
• Ability to use a telephone/headset and PC/keyboard simultaneously and sit for extended durations.
• May be required to work additional hours beyond the standard work schedule.

Nice To Haves

• Master’s degree.
• 10–15 years of Medicare Advantage experience.

Responsibilities

• Develop provider networks that meet goals for access, membership, quality, medical cost, and earnings, using risk-based structures and incentives where possible.
• Collaborate with the VP and President on network strategies, risk-sharing and payment models, and performance incentives.
• Monitor industry, provider-landscape, and federal and state payment-policy changes and apply relevant knowledge to network development and performance.
• Lead contract managers negotiating financial, operational, regulatory, and legal parameters with physician groups, ACOs, and hospitals.
• Coach, support, and train staff in developing proposals, strategies, and options for negotiations; support negotiations as needed.
• Develop negotiation strategy and lead negotiations with the largest provider systems.
• Assess, monitor, and manage network adequacy to meet federal and state regulations; identify and close network gaps.
• Collaborate with Enterprise Allied Health Contracting on allied health and behavioral health/substance abuse networks and payment terms, and assess allied payment rates and methodologies.
• Work with Enterprise Network Operations to support timely and accurate contract implementation, configuration, and ongoing administration.
• Build and implement proactive relationship management with strategic providers.
• Work with the provider performance team to monitor provider and network performance, advise on improvement plans, and identify supportive contract strategies and incentives.
• Collaborate with operations, professional relations, and other functions to identify and resolve provider issues.
• Communicate and engage with function leaders and stakeholders, and participate in or chair leadership meetings on provider strategy and network development.
• Develop and coach staff in negotiation, performance analysis, and relationship management.
• Perform 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.
• Benefits supporting career development, individual and family health, and financial health.
• Eligible for variable pay; bonus, commission, benefits, and other compensation are subject to the company’s discretion.

What This Job Offers

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