Manager, Payer Strategy & Contracting (Hybrid)

Company: Partners Healthcare System
Location: Somerville
Posted on: September 22, 2022

Job Description:

Description -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.

GENERAL SUMMARY/OVERVIEW STATEMENT:

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 (MGB) and advanced knowledge of the health care market. 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
--- - - -Provider network development

The Manager will participate with department leadership in the development and implementation of an overall strategy that addresses emerging contractual issues and opportunities that may result from changes in payment models, payment policies, regulations, and other business operations. Specifically, the Manager will lead the research, organization, and assessment of relevant contractual provisions; develop and present complex decision support materials for a variety of audiences (including senior leadership); organize and lead negotiations with health plans and other constituents in conjunction with department leadership; develop clear and concise written materials (project plans, presentations, decision documents, proposals, and contract documents), and thinking critically about the implications of contract provisions on MGB's operations.

The 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; have the ability to assess, understand, and integrate financial and other data; and have the ability to lead a multi-disciplinary group of internal constituents in a matrix environment.

PRINCIPAL DUTIES AND RESPONSIBILITIES:

Possess and continuously develop extensive knowledge of the healthcare market, including facts, concepts, and trends that are general to the industry as well as specific to Partners and the Payer Strategy and Contracting group.Manage multiple projects comprising cross-functional internal teams (including Contracting, Contract Finance, MGB Population Health Management, General Counsel, Business Planning, Government Payment Policy, Government Relations, Community Health, and other specific 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 (in conjunction/collaboration with various constituents) the generation of key questions, analytics, options for consideration, risks/opportunities, best practices, and ultimately recommendations for decision support.Develop written proposals for contract negotiations and complex contract language to reflect negotiated agreements, taking into account potential implications across the organization.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 responsibilities as assigned.
Qualifications -QUALIFICATIONS:

Bachelor's degree required (Masters preferable) in related fields such as business, health care administration, health care management, finance or law. -Healthcare background and previous exposure to healthcare policy a plus.Experience working with external clients a plus.

SKILLS/ABILITIES/COMPETENCIES REQUIRED:

Proven ability to think about a problem by skillfully analyzing, assessing and reconstructing (financial and non-financial) information in order to determine solutions.Proven ability to effectively lead the management of a multi-disciplinary project.Proven ability to work with and present concepts to a wide range of audiences.Proven ability to effectively communicate both verbally and in writing.Ability to design, develop, interpret, and synthesize financial data/analysis and contractual provisions, and to communicate about them both verbally and in writing.Familiarity with financial analytics and some ability to manipulate data in MS Excel.MS PowerPoint knowledge a plus

WORKING CONDITIONS:

Hybrid remote and office environment (desk and telephone work) with minimal regional business travel (primarily by automobile.) Minimal lifting.

1 day per week onsite, onsite meetings with payers as needed.

Location: Assembly Row: 399 Revolution Drive, Somerville, MA
EEO Statement -Mass General Brigham is an Equal Opportunity Employer. -By embracing diverse skills, perspectives and ideas, we choose to lead. All qualified applicants will receive consideration for employment without regard to race, color, religious creed, national origin, sex, age, gender identity, disability, sexual orientation, military service, genetic information, and/or other status protected under law. We will ensure that all individuals with a disability are provided a reasonable accommodation to participate in the job application or interview process, to perform essential job functions, and to receive other benefits and privileges of employment. - -Primary Location: -MA-Somerville-MGB Assembly RowWork Locations: -MGB Assembly Row -399 Revolution Drive - -Somerville -02145Job: -Auditing/ComplianceOrganization: -Mass General Brigham(PHS)Schedule: -Full-timeStandard Hours: -40Shift: -Day JobEmployee Status: -RegularRecruiting Department: -MGB Finance, Analytics & PlanningJob Posting: -Aug 29, 2022

Keywords: Partners Healthcare System, Somerville , Manager, Payer Strategy & Contracting (Hybrid), Executive , Somerville, Massachusetts