Senior Manager, Network Performance
About The Position
The Senior Manager, Network Performance works with the Director of Contract Analytics and the broader Contracting team to lead analytical support for contract negotiations, strategic initiatives, and regulatory requests. The role manages analysts and provides training and mentoring to team members, while directly supporting complex analyses related to negotiations and provider contracts. The Senior Manager also participates in external provider meetings with Contract Managers and oversees data preparation for regulatory requests. The position leads analysis of the financial effects of provider contracts and payment changes; supports annual commercial provider-network re-contracting; coordinates with internal departments on provider risk arrangements; and identifies opportunities to improve financial performance through payment arrangements. It also oversees team tools and provider-performance reviews, evaluates financial models and processes, supports service costing for Actuarial product pricing, manages staff and workload, and supports Sales RFPs as needed.
Responsibilities
- Manage analysts in designing and executing complex analyses to measure the financial impact of provider contracts and payment changes.
- Maintain broad knowledge of provider contractual arrangements, including value-based reimbursement mechanisms and key cost and utilization performance drivers.
- Submit regulatory requests and manage data preparation in support of them.
- Coordinate and oversee annual re-contracting of the provider network for commercial business.
- Work with Network Contracting, Provider Analytics, Accounting, Trends and Reserving to maintain open communication regarding provider risk deals.
- Lead the team in identifying opportunities to improve Point32Health’s financial position through enhanced payment arrangements.
- Manage the development and enhancement of department tools for standard work.
- Coordinate quarterly team reviews of provider performance assessments.
- Work with analytic staff to evaluate and recommend new financial models and processes.
- Participate in external provider meetings with Network Contracting staff.
- Manage costing of network services to assist Actuarial with product pricing.
- Recruit, train, develop, and evaluate staff performance.
- Manage team workload to meet quality standards and customer timelines.
- Support Sales RFPs as appropriate.
- Perform other duties and projects as needed.
Benefits
- Medical coverage
- Dental coverage
- Vision coverage
- Retirement plans
- Paid time off
- Employer-paid life insurance, with additional buy-up coverage options
- Employer-paid disability insurance, with additional buy-up coverage options
- Tuition program
- Well-being benefits
- Benefits supporting career development, individual and family health, and financial health
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What This Job Offers
Job Type
Full-time
Career Level
Senior
Education Level
No Education Listed
