Director, Contracting

Point32Health • Canton, MA

5d • $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 that negotiates contracts, including risk arrangements, to support high-performing provider networks and goals for membership growth, quality, and financial performance. The role also fosters strong relationships with strategic providers to help achieve shared plan and provider objectives.

As a member of the leadership team, the Director participates in division strategy, planning, and performance initiatives. The position 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 collaborating with providers.
• Energetic, goal-driven leadership and a proven ability to deliver results and lead teams toward goals.
• Strong working knowledge of managed care and risk-contracting payment methodologies.
• Negotiation expertise and experience with a range of provider payment methodologies, including risk.
• Demonstrated experience in direct, high-level negotiations, with the ability to close deals while maintaining relationships.
• Strong 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 and ability to influence and work collaboratively 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 and constructive behavior in challenging situations.
• Strategic thinking and planning ability.
• Ability to assess and address the interests of both the enterprise and providers.
• Strong collaboration skills and ability to work 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 to meet goals for access, membership, quality, medical cost, and earnings.
• Build and maintain high-performing provider networks, using risk-based structures and incentives whenever possible.
• Identify and recommend network changes to advance business goals.
• Collaborate with the VP and President on network strategies, risk-sharing and payment models, and performance incentives to support cost and quality goals.
• Monitor industry trends, provider landscape changes, and federal and state payment policies and methodologies, and use this knowledge to advance network development and performance.
• Direct contract managers negotiating financial, operational, regulatory, and legal contract terms with physician groups, ACOs, and hospitals, in line with business goals and regulatory timelines.
• Coach, support, and train staff in developing proposals, strategies, and options for contract negotiations.
• Support negotiations as needed and devise strategy for, lead, and negotiate agreements with the largest provider systems.
• Assess, monitor, and manage network adequacy to meet federal and state regulations; proactively identify and close network gaps.
• Collaborate with Enterprise Allied Health Contracting so allied health and BH/SA networks and payment terms support Medicare division needs and goals.
• Assess and monitor allied health payment rates and recommend methodology and rate changes to align incentives and manage expense trends.
• Collaborate with Enterprise Network Operations on timely and accurate contract implementation, configuration, and ongoing contract administration.
• Develop and implement proactive relationship management with strategic providers to support long-term, mutually successful relationships.
• Work with the provider performance team to understand and monitor provider and network performance; advise on improvement plans and identify contract strategies and incentives to support improvement.
• Collaborate with operations, professional relations, and other functions to identify and resolve provider issues.
• Communicate and engage proactively with functional leaders and key stakeholders; participate in or chair leadership meetings on provider strategy, network development, and related issues.
• Develop and coach staff in negotiation, performance analysis, and relationship management to build a high-performing team of provider professionals.
• Perform other duties and projects as assigned.

Benefits

• Medical coverage
• Dental coverage
• 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
• Eligibility for variable pay; bonus, commission, and other compensation or benefits are subject to the company’s discretion

What This Job Offers

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