Senior Health Policy and Contracting Specialist
Senior Health Policy and Contracting Specialist
Posted on :
10-04-2025
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1 Vacancy
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Monthly Salary
Not Disclosed
Salary Not Disclosed
Vacancy
1 Vacancy
Posted on :
10-04-2025
Job Description
As a notforprofit organization Partners HealthCare is committed to supporting patient care research teaching and service to the community by leading innovation across our system. Founded by Brigham and Womens Hospital and Massachusetts General Hospital Partners HealthCare 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 healthrelated entities. Several of our hospitals are teaching affiliates of Harvard Medical School and our system is a national leader in biomedical research.
Were focused on a peoplefirst culture for our systems patients and our professional family. Thats why we provide our employees with more ways to achieve their potential. Partners HealthCare 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 developmentand we recognize success at every step.
Our employees use the Partners HealthCare 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.
The Senior Health Policy and Contracting Specialist will support the Payer Strategy and Contracting team in the development of strategies for negotiation analysis implementation and ongoing maintenance of Partners contracts and related health policy issues associated with health insurance plans. Day to day responsibilities include but are not limited to: researching organizing and assessing contractual issues (health care policy health care payment financial and related internal provider operational issues etc. assisting in the development of complex decision support materials for a variety of audiences (including senior Partners leadership) assisting in the organization of negotiations with health insurance plans and other constituents assisting in the development of clear and concise written materials (project plans presentations proposals and contract documents) demonstrating intellectual ownership by developing a strong understanding of contract provisions and communicating such issues to Partners operations and provider teams (described broadly as: hospitals physicians health centers central billing and operations areas and clinical program areas).
This position requires knowledge of the health policy and the health care market the ability to translate complex information into simple terms and strategic and critical thinking skills. The position also requires strong organizational and project management skills; the ability to work as part of a team in a matrix environment and strong written and verbal communication skills; and the ability to understand and integrate financial data as part of key decision support processes.
1. Act as coordinator for Partners interdepartmental workgroup teams responsible for negotiating contracts and researching health policy issues as it related to Partners contracts with external health insurance plans
2. Build relationships and maintain communications with counterparts at health insurance plans constituents within Partners and other key stakeholders
3. Collaborate with system wide Partners constituents to generate analysis of key questions and concerns that should be integrated into contract negotiations; synthesize results for decision support/ presentation to a variety of audiences
4. Develop complex presentation materials for a variety of audiences including senior leadership
5. Develop and document written proposals incorporating financial and nonfinancial contract terms
6. Interpret contract language and respond to questions from internal and external constituents
7. Other responsibilities as assigned (will grow with experience)
Partners HealthCare 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.
Proficiency in Microsoft Word and PowerPoint
Experience with Microsoft Excel
Bachelors degree required; Masters degree in related field preferred
Five years work experience required a background in healthcare or exposure to health care policy preferred
Prior contracting experience is not required the skills and competencies below are most critical.
Experience working with external clients would be a plus.
Were focused on a peoplefirst culture for our systems patients and our professional family. Thats why we provide our employees with more ways to achieve their potential. Partners HealthCare 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 developmentand we recognize success at every step.
Our employees use the Partners HealthCare 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.
Responsibilities:
The Payer Strategy and Contracting group is responsible for the negotiation and management of contracts with health insurance plans and third party payers on behalf of Partners HealthCare System Inc. (Partners) providers. The Payer Strategy and Contracting group evaluates key health policy healthcare payment and healthcare market issues that arise from or are addressed through Partners relations with Medicare Medicaid and Commercial health insurance plans. Examples of such issues include but are not limited to:
Payment and payment reform
Healthcare reform
Quality performance incentives and measurement
Provider network development
Introduction of new care models like Patient Centered Medical Home Urgent Care and TeleHealth.
Price transparency
Accountable care organization progress and development
Management of medical cost trend
Payment and payment reform
Healthcare reform
Quality performance incentives and measurement
Provider network development
Introduction of new care models like Patient Centered Medical Home Urgent Care and TeleHealth.
Price transparency
Accountable care organization progress and development
Management of medical cost trend
The Senior Health Policy and Contracting Specialist will support the Payer Strategy and Contracting team in the development of strategies for negotiation analysis implementation and ongoing maintenance of Partners contracts and related health policy issues associated with health insurance plans. Day to day responsibilities include but are not limited to: researching organizing and assessing contractual issues (health care policy health care payment financial and related internal provider operational issues etc. assisting in the development of complex decision support materials for a variety of audiences (including senior Partners leadership) assisting in the organization of negotiations with health insurance plans and other constituents assisting in the development of clear and concise written materials (project plans presentations proposals and contract documents) demonstrating intellectual ownership by developing a strong understanding of contract provisions and communicating such issues to Partners operations and provider teams (described broadly as: hospitals physicians health centers central billing and operations areas and clinical program areas).
This position requires knowledge of the health policy and the health care market the ability to translate complex information into simple terms and strategic and critical thinking skills. The position also requires strong organizational and project management skills; the ability to work as part of a team in a matrix environment and strong written and verbal communication skills; and the ability to understand and integrate financial data as part of key decision support processes.
1. Act as coordinator for Partners interdepartmental workgroup teams responsible for negotiating contracts and researching health policy issues as it related to Partners contracts with external health insurance plans
Research and organize information required for contract negotiations (health care policy health care payment financial and related internal operational issues etc.Assist in the development of negotiating strategy and tacticsAssist in project management for external contract negotiations including tracking issues and key decisions that have been made and effectively managing projects to completionParticipate in negotiation sessions with health insurance plans
2. Build relationships and maintain communications with counterparts at health insurance plans constituents within Partners and other key stakeholders
3. Collaborate with system wide Partners constituents to generate analysis of key questions and concerns that should be integrated into contract negotiations; synthesize results for decision support/ presentation to a variety of audiences
4. Develop complex presentation materials for a variety of audiences including senior leadership
5. Develop and document written proposals incorporating financial and nonfinancial contract terms
6. Interpret contract language and respond to questions from internal and external constituents
7. Other responsibilities as assigned (will grow with experience)
Proficiency in Microsoft Word and PowerPoint
Experience with Microsoft Excel
Bachelors degree required; Masters degree in related field preferred
Five years work experience required a background in healthcare or exposure to health care policy preferred
Prior contracting experience is not required the skills and competencies below are most critical.
Experience working with external clients would be a plus.
Skills/Abilities/Competencies:
Maintain a continually evolving knowledge base of the health care market including facts concepts and trends that are general to the industry including Medicare and Medicaid health care reform and specific to Partners and the work of the department
Ability to think strategically and critically; think about a problem by analyzing assessing and reorganizing information in order to develop well reasoned recommendations and solutions testing against relevant criteria/standards and assessing in the context of the environment and organizational priorities
Works well as part of a team in a matrixed environment with multiple constituents. Able to influence others without relying on formal authority and to manage conflicts that arise while moving groups towards consensus and/or a decision.
Excellent customer service skills providing accurate and reliable information to constituents and maintaining professional relationships with key contacts.
Able to reach agreement based on the merits of the issues and to create an outcome that has mutual benefits for the parties involved.
Effectively use various tools to initiate a project monitor progress anticipate obstacles and provide concise updates in a timely manner. Take into consideration the people impacted by the project and understands how the project fits into the bigger picture of the organization
Ability to understand an issue from a broad and detailed perspective demonstrating intellectual ownership of an issue through managing the pathway to discovery and analysis
Strong verbal and written capabilities; able to accurately and concisely convey complex issues lay out well reasoned arguments organize and present findings and recommendations to a wide range of audiences
Ability to interpret and synthesize financial data/analysis design and develop contractual provisions payer agreements and policies and to communicate about such concepts both verbally and in writing
Demonstrates intellectual ownership and a sense of responsibility for ones work e.g. proactive in identifying issues prepared to address concerns/questions makes recommendations
Ability to think strategically and critically; think about a problem by analyzing assessing and reorganizing information in order to develop well reasoned recommendations and solutions testing against relevant criteria/standards and assessing in the context of the environment and organizational priorities
Works well as part of a team in a matrixed environment with multiple constituents. Able to influence others without relying on formal authority and to manage conflicts that arise while moving groups towards consensus and/or a decision.
Excellent customer service skills providing accurate and reliable information to constituents and maintaining professional relationships with key contacts.
Able to reach agreement based on the merits of the issues and to create an outcome that has mutual benefits for the parties involved.
Effectively use various tools to initiate a project monitor progress anticipate obstacles and provide concise updates in a timely manner. Take into consideration the people impacted by the project and understands how the project fits into the bigger picture of the organization
Ability to understand an issue from a broad and detailed perspective demonstrating intellectual ownership of an issue through managing the pathway to discovery and analysis
Strong verbal and written capabilities; able to accurately and concisely convey complex issues lay out well reasoned arguments organize and present findings and recommendations to a wide range of audiences
Ability to interpret and synthesize financial data/analysis design and develop contractual provisions payer agreements and policies and to communicate about such concepts both verbally and in writing
Demonstrates intellectual ownership and a sense of responsibility for ones work e.g. proactive in identifying issues prepared to address concerns/questions makes recommendations
Required Experience:
Senior IC
Employment Type
Full-Time
Key Skills
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