Sr Contract Manager

Point32Health • Canton, MA

1d • $106,448 - $159,672 • Remote

About The Position

Point32Health is a leading not-for-profit health and well-being organization dedicated to delivering high-quality, affordable healthcare. Serving nearly 2 million members, Point32Health builds on the legacy of Harvard Pilgrim Health Care and Tufts Health Plan to provide access to care and empower healthier lives for everyone. Our culture revolves around being a community of care and having shared values that guide our behaviors and decisions. We’ve had a long-standing commitment to inclusion and equal healthcare access and outcomes, regardless of background; it’s at the core of who we are. We value the rich mix of backgrounds, perspectives, and experiences of all of our colleagues, which helps us to provide service with empathy and better understand and meet the needs of the communities where we serve, live, and work. We enjoy the important work we do every day in service to our members, partners, colleagues and communities. Learn more about who we are at Point32Health. Job Summary The Senior Contract Manager serves as the primary point of contact with providers to negotiate every aspect of contracts with large physician and hospital organizations. This individual is the primary lead during negotiations and is accountable for the financial and legal terms negotiated with the providers, which includes multiple risk arrangements, quality incentives and contract language elements. In addition, this individual will ensure that contract terms are consistent with the Commercial contracting strategy and are negotiated within the established legal and financial guidelines as established by Point32Health.

Requirements

• Excellent communication skills, both oral and written.
• Established presentation and influencing skills
• Demonstrated strength in finance to support financial contract components and analysis
• Ability to independently research, interpret, communicate, and resolve complex issues
• Advanced analytic ability with proficiency in Microsoft Word, Excel, and PowerPoint applications
• Excellent time management skills to manage multiple priorities to deadline
• Must be able to work under normal office conditions and work from home as required.
• Work may require simultaneous use of a telephone/headset and PC/keyboard and sitting for extended durations.
• May be required to work additional hours beyond standard work schedule.
• Bachelor’s Degree
• 5-7 years in managed healthcare. Experience in contract negotiations preferred, including familiarity with various payment methodologies.

Nice To Haves

• Master’s Degree
• 8-10 years of related work experience

Responsibilities

• Lead the negotiation of contractual arrangements with established or potential network providers, within budgeted targets, administrative requirements, and regulatory requirements.
• Direct financial analyses to support contract negotiations, independently develop proposals oversee the development of contract documents, and compose comprehensive contracts inclusive of contractual conditions, legal terms, and financial elements, for successful implementation.
• Work closely with the legal department to ensure contract provisions are consistent across providers and ensure all applicable legal terms are included in the signed contract.
• Understand organizational, state-level, and national laws and regulations to ensure contract language meets compliance standards.
• Articulate to Network providers, including individuals at the executive level, Point32Health’s position on key issues relevant to the contract negotiation.
• Senior Contract manager to be well versed in publicly reported financial data such as provider relative price, total medical expense, and hospital 403 cost information for use in negotiations.
• Senior CMs also responsible for negotiating terms of multiple risk arrangements across all products and clearly defining those terms.
• Senior CMs work closely with partner departments (clinical, reporting, quality) to develop key objectives for the contract cycle.
• Manage and position the negotiation so that Point32Health meets the key objectives that have been identified for the contracting cycle.
• Understand, with a high degree of specificity, important business aspects such as global budget models across all products, unit cost trend, provider financial performance, and any analytical tools utilized the Point32Health to understand the performance, financial and otherwise, of the provider network.
• Lead and/or participate in cross functional meetings throughout the organization; lead internal ad hoc groups to address contracting issues, communicate status of negotiations and document key financial and legal terms.
• At manager’s discretion, maintain ownership and the development of at least one key negotiation tool or support function (sales, government affairs etc.)
• Primary relationship contacts with provider organization during negotiation
• 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