Contract Manager

Partners Healthcare System Somerville , MA 02143

Posted 2 weeks ago

About Us

As a not-for-profit organization, Mass General Brigham is committed to supporting patient care, research, teaching, and service to the community by leading innovation across our system. Founded by Brigham and Women's Hospital and Massachusetts General Hospital, Mass General Brigham supports a complete continuum of care including community and specialty hospitals, a managed care organization, a physician network, community health centers, home care and other health-related entities. Several of our hospitals are teaching affiliates of Harvard Medical School, and our system is a national leader in biomedical research.

We're focused on a people-first culture for our system's patients and our professional family. That's why we provide our employees with more ways to achieve their potential. Mass General Brigham is committed to aligning our employees' personal aspirations with projects that match their capabilities and creating a culture that empowers our managers to become trusted mentors. We support each member of our team to own their personal development-and we recognize success at every step.

Our employees use the Mass General Brigham values to govern decisions, actions and behaviors. These values guide how we get our work done: Patients, Affordability, Accountability & Service Commitment, Decisiveness, Innovation & Thoughtful Risk; and how we treat each other: Diversity & Inclusion, Integrity & Respect, Learning, Continuous Improvement & Personal Growth, Teamwork & Collaboration.

Summary

The Payer Strategy and Contracting group is seeking a candidate with an in-depth understanding of a broad range of health policy issues facing Mass General Brigham the health care market to manage and conduct contract negotiations with third-party payers. The Contracting Manager must have the ability to think independently, critically, strategically, broadly, and creatively; possess exceptional organizational and project management skills; have excellent written and verbal communication skills; can assess, understand, and integrate financial and other data; and can lead a multi-disciplinary group of internal constituents in a matrix environment.

The Contracting Manager will assist in the development and implementation of an overall strategy for the department to support emerging contractual challenges and opportunities. This position will organize and lead negotiations with health plans and other constituents in conjunction with department leadership. The incumbent will lead the research, organization, development and assessment of relevant contractual provisions. The Contracting Manager will also develop and present complex decision support materials to multiple audiences.

Department Overview:

The Payer Strategy and Contracting group evaluates key health policy, healthcare payment, and healthcare market issues in the context of MGB relations with commercial payers, Medicare, and Medicaid. The group is responsible for implementing key policy positions through the negotiation and management of contracts with health insurance plans and third-party payers on behalf of MGB providers. Examples of policy issues include:

  • Payment and reimbursement issues

  • Healthcare reform and regulatory issues

  • Value-based care, including risk sharing and pay-for-performance quality incentive arrangements

  • Reimbursement for innovative therapies and services

  • New care models such as telehealth and home-based care

  • Price transparency

  • Pricing strategy

  • Provider network development

Principle Duties and Responsibilities

  • Lead, manage and support complex contract negotiations with a variety of third party payers, including commercial and government plans. Develop written proposals for contract negotiations and complex contract language to reflect negotiated agreements, considering potential implications across the organization.

  • Use/s the Mass General Brigham values to govern decisions, actions, and behaviors. These values guide how we get our work done: Patients, Affordability, Accountability & Service Commitment, Decisiveness, Innovation & Thoughtful Risk; and how we treat each other: Diversity & Inclusion, Integrity & Respect, Learning, Continuous Improvement & Personal Growth, Teamwork & Collaboration.

  • Acts as a Subject Matter Expert in regard to the healthcare market for the organization and the Payer Strategy and Contracting group.

  • Manage multiple projects comprising cross-functional internal teams, including colleagues both at MGB corporate and at the network entities, as well as external constituents.

  • Build and continuously foster relationships with internal and external counterparts and other key stakeholders.

  • Identify, research, and organize key information required for contract negotiations; and, in conjunction with department leadership, develop negotiating strategy and tactics and organize and lead external contract negotiations.

  • Develop and present complex presentation materials (incorporating financial terms) for a variety of audiences including senior leadership.

  • Proactively lead the generation of key questions, analytics, options for consideration, risks/opportunities, best practices, and ultimately recommendations for decision support.

  • Interpret contract language and respond to questions from internal and external constituents.

  • Staff supervision include recruitment, professional development, and performance management.

  • Assist in the oversight and prioritization of work assignments, monitor the quality and accuracy of deliverables, and ensure timely delivery of projects.

  • Other duties as assigned

Qualifications

  • Bachelor's degree required in related fields such as business, health care administration, health care management, finance, or law.

  • Master's degree preferred. Six plus years of closely related experience required.

  • Three plus years managing people preferred.

  • Must have experience with Negotiating Payer Contracts. Healthcare background and previous exposure to healthcare policy required.

  • Experience working with external clients preferred

  • A combination of education and experience may be substituted for requirements

Skills, Abilities and Competencies

  • Possess strong interpersonal skills to effectively communicate with cross functional teams including staff at all levels of the organization, both verbally and in writing.

  • Ability to successfully negotiate and collaborate with others of different skill sets, backgrounds, and levels within and external to the organization

  • Strong problem solving and negotiation skills

  • Ability to effectively conduct meetings, both formal and informal

  • Requires minimal direction from leadership and possesses the ability to learn quickly

  • Proven ability to think creatively about a problem by skillfully analyzing, assessing, and reconstructing (financial and non-financial) information to determine solutions.

  • Ability to design, develop, interpret, and synthesize financial data/analysis

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