Senior Manager, Value-Based Contract Modeling

Mass General Brigham•Somerville, MA

1d•Remote

About The Position

The Senior Manager of Value-Based Contract Modeling serves as the domain owner for financial modeling infrastructure supporting value-based healthcare contracts within Population Health Finance. This role is responsible for the development, maintenance, and evolution of standardized financial models across all lines of business, including Medicare (Traditional and Medicare Advantage), Medicaid, and Commercial risk arrangements. The role supports a broad and growing portfolio of value-based payment models, such as MSSP, ACO REACH, Medicare Advantage risk contracts, Medicaid programs, and Commercial value-based arrangements. The position operates under the strategic direction of the Director of Value-Based Performance, who defines modeling priorities, assumptions, and overall financial strategy. This role is accountable for translating that strategy into scalable, well-governed modeling infrastructure and ongoing financial projections. The role supports financial planning, benchmarking, and settlement analysis across multiple contract types and requires deep expertise in healthcare reimbursement mechanics, benchmark and trend modeling, and scenario-based financial forecasting. This role partners closely with finance, actuarial, analytics, and clinical leadership to translate cost, utilization, risk, and quality performance analytics into forward-looking financial projections used for strategic decision making.

Requirements

Bachelor’s Degree in Finance, Economics, Healthcare Administration, Data Analytics, or related field required.
8 –10+ years of experience in healthcare financial modeling, actuarial analytics, medical economics, or value-based payment analytics.
Experience supporting Medicare (Traditional and Medicare Advantage), Medicaid, and/or Commercial risk-based payment models strongly preferred.
Demonstrated experience developing complex financial models and scenario-based projections for healthcare contracts.
5 –7 years of previous supervisory or leadership experience required.
Strong knowledge of healthcare reimbursement methodologies and payment models across Medicare (Traditional and Medicare Advantage), Medicaid, and Commercial risk contracts.
Understanding of value-based payment models including shared savings, downside risk, capitation, benchmark methodologies, and risk corridors across payer types.
Experience supporting or analyzing value-based program structures across Medicare ACO models, Medicare Advantage, Medicaid programs, and Commercial value-based arrangements.
Understanding of risk adjustment methodologies, including CMS-HCC and other payer-specific risk models.
Advanced financial modeling capabilities in Excel, including development of scenario-based forecasting models and sensitivity analyses.
Experience building and maintaining complex financial models that incorporate healthcare contract mechanics (e.g., benchmark methodologies, trend, risk adjustment, shared savings structures).
Proficiency in SQL required; Experience working with large healthcare datasets, including claims, enrollment, and risk score data.
Ability to translate analytic outputs (cost, utilization, risk, quality) into structured financial modeling inputs.
Ability to translate complex financial and analytic concepts into actionable insights.
Strong communication and presentation skills with the ability to convey technical concepts to both technical and non-technical stakeholders.
Strong strategic thinking and problem-solving capabilities.

Nice To Haves

Master’s Degree in a related field preferred.
Equivalent experience may be accepted in lieu of a degree.
Experience with data visualization platforms such as Tableau or Power BI to support model outputs and executive reporting preferred, but not required.

Responsibilities

Develop, maintain, and enhance standardized financial models supporting value-based healthcare contracts across Medicare (Traditional and Medicare Advantage), Medicaid, and Commercial lines of business.
Operationalize modeling assumptions and methodologies defined by Finance leadership into scalable financial models across multiple contract types.
Model benchmark methodologies, trend assumptions, risk normalization, and shared savings mechanics across diverse payer structures.
Build scenario-based financial projections to assess upside and downside exposure under varying cost, risk score, and quality performance assumptions across lines of business.
Support financial planning and forecasting processes for value-based contracts across the enterprise portfolio.
Analyze contract settlement results and perform variance analysis relative to projected financial performance.
Evaluate benchmark gaps and financial performance relative to contract targets.
Translate cost, utilization, risk, and quality performance analytics into financial projections and modeling inputs.
Partner with actuarial, finance, analytics, and clinical leadership to evaluate the financial implications of value-based payment models and contract design.
Support strategic planning and contract negotiations through financial modeling and sensitivity analyses.
Establish standardized modeling methodologies across contracts and lines of business.
Maintain documentation of model assumptions, methodologies, and version control to ensure financial governance and transparency.
Partner with analytics and data engineering teams to ensure financial models are supported by scalable analytic datasets.
Prepare financial scenario analyses and projections used to inform executive decision making.
Provide insights on financial exposure, savings drivers, and performance risks across value-based contracts.