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Contract Manager

Company: TalentBoost (Point32Health)
Location: Swampscott
Posted on: November 26, 2022

Job Description:

The 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. -KEY RESPONSIBILITIES/ESSENTIAL FUNCTIONS:

  • 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. 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. CMs also responsible for negotiating terms of multiple risk arrangements across all products and clearly defining those terms. CM works 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 by 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 contact with provider organization during the course of negotiation -EDUCATION: Bachelor's Degree required. Master's Degree in Business Administration or other advanced degree preferred.EXPERIENCE: 5 to 7 years in managed healthcare. Experience in contract negotiations preferred, including familiarity with various payment methodologies.SKILL 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 -WORKING CONDITIONS AND ADDITIONAL REQUIREMENTS:
      • Some day travel throughout MA, RI and NH. -Commitment to Diversity, Equity & InclusionPoint32Health is committed to making diversity, equity, and inclusion part of everything we do-from product design to the workforce driving that innovation. Our DEI strategy is deeply connected to our core values and will evolve as the changing nature of work shifts. Programming, events, and an inclusion infrastructure play a role in how we spread cultural awareness, train people leaders on engaging with their teams and provide parameters on how to recruit and retain talented and dynamic talent. We welcome all applicants and qualified individuals, who will receive consideration for employment without regard to race, color, religion, gender, gender identity or expression, sexual orientation, national origin, genetics, disability, age, or veteran status. -COVID PolicyPlease note: As of January 18, 2022, all employees - including remote employees - must be fully vaccinated. This position will require the successful candidate to show proof of full vaccination against COVID-19. Point32Health is an equal opportunity employer, and will consider reasonable accommodation to those individuals who are unable to be vaccinated consistent with federal, state, and local law. -About the CompanyPoint32Health is a leading health and wellbeing organization, delivering an ever-better personalized health care experience to everyone in our communities. At Point32Health, we are building on the quality, nonprofit heritage of our founding organizations, Tufts Health Plan and Harvard Pilgrim Health Care, where we leverage our experience and expertise to help people find their version of healthier living through a broad range of health plans and tools that make navigating health and wellbeing easier.We enjoy the important work we do every day in service to our members, partners, colleagues and communities.This job has been posted by TalentBoost on behalf of Point32Health. TalentBoost is committed to the fundamental principle of equal opportunity and equal treatment for every prospective and current employee. It is the policy of TalentBoost not to discriminate based on race, color, national or ethnic origin, ancestry, age, religion, creed, disability, sex and gender, sexual orientation, gender identity and/or expression, military or veteran status, or any other characteristic protected under applicable federal, state or local law.Req ID: R5257

Keywords: TalentBoost (Point32Health), Boston , Contract Manager, Accounting, Auditing , Swampscott, Massachusetts

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