Senior Value-Based Contracts Leader

EmblemHealth; New York (NY); On-site; USD 93,000 - 178,000; Full time

Job summary

EmblemHealth seeks a senior professional to negotiate and manage value-based relationships with multispecialty groups, FQHCs, IPAs, and hospital partners in New York. You will lead a team of contract specialists, build end-to-end financial processes, and drive cost, value, and market pricing improvements.

You will travel across NYS, work with Finance, Health Care Economics and Analytics teams, and oversee regulatory reporting, ensuring contracts meet performance metrics and governance

Qualifications

• Bachelor's degree required; master's preferred (MBA, MPH, MA).
• 10+ years' relevant, professional healthcare provider experience (Required).
• Network management and contracting experience (Required).
• 3+ years' experience in managing staff and processes (Required).
• Experience with value-based plans/processes (Preferred).
• Health plan financial operations and data analysis experience (Preferred).
• Project management experience (Preferred).
• Comprehensive understanding of contractual options, healthcare economics, and competitors' practices with ability to grasp both clinical and business concepts (Required).
• Excellent communication skills - verbal, written, presentation, interpersonal with all levels and types/levels of audiences (Required).
• Ability to develop and implement performance measures and metrics (Required).
• Proficient with MS Office - Word, Excel, PowerPoint, Outlook (Required).
• Willingness and ability to travel throughout assigned markets and participate on-site in provider meetings and field activities within the 13 downstate counties (10%) (Required).

Responsibilities

• Identify, design, negotiate, contract, and manage new and existing strategic partners across value-based models.
• Research federal, state, and competitor strategies on value-based payments for compliance and improvements.
• Establish oversight of contract performance by defining and tracking metrics.
• Serve as value-based SME for regulatory reporting and RFI/RFP responses.
• Maintain PADU for value-based provider contracts and ensure system updates.
• Track and implement contract terms in systems and mitigate deficiencies.
• Collaborate with stakeholders to improve internal workflows and provider relationships.
• Oversee end-to-end financial accounting for value-based contracts and related payments.
• Lead contract reconciliations and inform Finance of reserves and accruals.
• Ensure contract databases support forecasting and budgeting.
• Develop and mentor team members to drive value across provider types.
• Set team objectives and measure performance to goals.
• Foster cross-functional relationships to influence roadmaps and support initiatives.
• Lead provider network projects, including cost optimization and pricing improvements.

Skills

Communication skills

Cross-functional leadership

Project management

MS Office proficiency

Education

Bachelor's degree

Master's degree (MBA/MPH/MA)

Tools

MS Office

Job description

EmblemHealth seeks a senior professional to negotiate and manage value-based relationships with multispecialty groups, FQHCs, IPAs, and hospital partners in New York. You will lead a team of contract specialists, build end-to-end financial processes, and drive cost, value, and market pricing improvements.

You will travel across NYS, work with Finance, Health Care Economics and Analytics teams, and oversee regulatory reporting, ensuring contracts meet performance metrics and governance