Senior Contract Manager

Blue Cross and Blue Shield of Massachusetts Inc.; Boston (MA); On-site; USD 134,000 - 164,000; Full time

Benefits offered by this job

Paid time off

Medical/dental/vision insurance

401(k)

Job summary

Blue Cross Blue Shield of Massachusetts Inc. in Boston seeks a Senior Contract Manager to lead negotiations for hospital and physician contracts and to develop rate proposals with actuarial input.

The role requires strong financial, analytical, and modeling abilities, and a track record in value-based care contracting, with collaboration across legal, finance, and network teams.

Qualifications

• BS/BA required; Masters preferred; 7+ years demonstrated health care finance or policy experience, with 5+ years provider or payer contracting and negotiation experience preferred; demonstrated financial, analytic and modeling abilities; value-based care experience.

Responsibilities

• Lead negotiations for an assigned portfolio of contracts, which may include fee-for-service, pay-for-performance, and risk-sharing hospital and physician contracts, ensuring that both the business and financial objectives are achieved in all initiatives.
• Develop rate proposals using Excel-based modeling tools and work with Actuarial to obtain all other rate and utilization analytics needed to support contract negotiations.
• Draft contract language and financial terms, and ensure final contracts are accurate and complete.
• Communicate new contract terms and rates within the organization and implement them by the contract effective date.
• Contribute to creative contracting strategies, reimbursement structures, networks, and approaches to maximize BCBSMA's competitive position.

Skills

Negotiation

Financial modeling

Analytical skills

Communication skills

Team collaboration

Education

BS/BA in related field

Masters preferred

Tools

Excel

Job description

Ready to help us transform healthcare? Bring your true colors to blue.

Description: BCBSMA has been a national leader in implementing value-based payment models like the Alternative Quality Contract and most recently announced our intent to collaborate with providers to develop incentives to reduce racial inequities in care. The Senior Contract Manager works closely with the Director of Network Contracting to successfully execute these innovative payment models and quality incentive programs, as well as achieve unit cost trend targets. The Senior Contract Manager is the primary negotiator for an assigned portfolio of hospital and physician organizations and is responsible for managing the end-to-end process of developing proposals, negotiating terms, and accurately drafting and finalizing contracting language and financial rates. A successful Senior Contract Manager is analytical, has high attention to detail, and is able to communicate persuasively and effectively, both verbally and in writing.

Major Responsibilities

• Lead negotiations for an assigned portfolio of contracts, which may include fee-for-service, pay-for-performance, and risk-sharing hospital and physician contracts, ensuring that both the business and financial objectives are achieved in all initiatives.
• Manage all aspects of negotiations including analyzing publicly available market data and internal data, developing proposal presentations and letters, negotiating terms with providers, liaising with the legal team and other business areas to assess risks, drafting contract language and financial terms, and ensuring that final contracts are accurate and complete.
• Develop rate proposals using Excel-based modeling tools and work with Actuarial to obtain all other rate and utilization analytics needed to support contract negotiations.
• Ensure new contract terms and rates are successfully communicated within the organization and implemented accurately as of the contract effective date.
• Work effectively with multiple departments to ensure that contracts align with our corporate strategy and are compatible with health plan operations, policies and procedures.
• Contribute to the development of creative contracting strategies, reimbursement structures, networks, and approaches that will maximize BCBSMA's competitive position and advance our corporate strategy.
• Facilitate and lead cross functional negotiation teams.

Qualifications

• Enhanced understanding of global, hospital and physician contract development
• demonstrated negotiation of complex provider payment arrangements
• demonstrated financial, analytical, and modeling abilities
• demonstrated understanding of value-based care and health care reimbursement methods and strategies
• Experience as a primary negotiator with large, complex hospital and physician organizations
• Demonstrated ability to influence, negotiate, and operate collaboratively as part of a team
• Excellent written/verbal communication skills
• effective presentation skills
• project management and planning skills critical
• Demonstrated ability to advance initiatives and work independently

Education and Experience

• BS/BA required; Masters preferred 7+ years demonstrated health care finance or policy experience, with 5+ years provider or payer contracting and negotiation experience preferred; demonstrated financial, analytic and modeling abilities; value-based care experience, substantial negotiations experience; strategic thinker; problem-solver; consensus builder; ability to effectively influence and interact effectively at all levels of management; team builder.
• This position is eligible for the Flex persona.
• Minimum Education Requirements: High school degree or equivalent required unless otherwise noted above.

Location

• Boston

Time Type

• Full time

Salary

• Salary Range: $134,275.47 - $164,120.00
• This job is also eligible for variable pay.

Benefits

• Comprehensive package of benefits including paid time off, medical/dental/vision insurance, 401(k), and a suite of well-being benefits to eligible employees.

Company Culture

You might be just what we need for this role or possibly another one at Blue Cross Blue Shield of MA.

The more voices we have represented and amplified in our business, the more we will all thrive, contribute, and be brilliant.

We encourage you to bring us your true colors, , your perspectives, and your experiences.

Its in our differences that we will remain relentless in our pursuit to transform healthcare for ALL.

As an employer, we are committed to investing in your development and providing the necessary resources to enable your success.

Learn how we are dedicated to creating an inclusive and rewarding workplace that promotes excellence and provides opportunities for employees to forge their unique career path by visiting our Company Culture page.

At Blue Cross Blue Shield of Massachusetts, we believe in wellness and that work/life balance is a key part of associate wellbeing.

Equal Employment Opportunity

Blue Cross Blue Shield of Massachusetts is an Equal Employment Employer - veterans/disability. Applicants are considered for all positions without regard to race, color, religion, sex, national origin, age, veteran status, disability, sexual orientation, gender identity or expression, or any other characteristics protected by law. Blue Cross Blue Shield of Massachusetts will not discharge or in any other manner discriminate against employees or applicants because they have inquired about, discussed, or disclosed their own pay or the pay of another employee or applicant. However, employees who have access to the compensation information of other employees or applicants as a part of their essential job functions cannot disclose the pay of other employees or applicants to individuals who do not otherwise have access to compensation information, unless the disclosure is (a) in response to a formal complaint or charge, (b) in furtherance of an investigation, proceeding, hearing, or action, including an investigation conducted by the employer, or (c) consistent with Blue Cross Blue Shield of Massachusetts's legal duty to furnish information.