Manager of Payer Strategy and Contracting
Manager of Payer Strategy and Contracting
Posted on :
11-04-2025
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1 Vacancy
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Monthly Salary
Not Disclosed
Salary Not Disclosed
Vacancy
1 Vacancy
Posted on :
11-04-2025
Job Description
About Us:
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.
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.
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 Payer Strategy and Contracting group is seeking a candidate with an indepth understanding of a broad range of health policy issues facing Partners HealthCare System Inc. (Partners) 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 Partners 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 Partners providers. Examples of policy issues include:
Payment and reimbursement issues
Payment reform and alternative payment models
Healthcare reform
Payforperformance quality incentive programs
Provider network development
New care models such as patientcentered medical homes urgent care and telehealth
Price transparency
Accountable care organization progress and development
Medical cost trend management
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 Partners 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 multidisciplinary group of internal constituents in a matrix environment.
Principal Duties and ResponsibilitiesPayment and reimbursement issues
Payment reform and alternative payment models
Healthcare reform
Payforperformance quality incentive programs
Provider network development
New care models such as patientcentered medical homes urgent care and telehealth
Price transparency
Accountable care organization progress and development
Medical cost trend management
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 Partners 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 multidisciplinary group of internal constituents in a matrix environment.
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 crossfunctional internal teams (including Contracting Contract Finance Partners 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.
Manage multiple projects comprising crossfunctional internal teams (including Contracting Contract Finance Partners 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
Bachelors degree required; masters degree in related field preferred.
Healthcare background and previous exposure to healthcare policy a plus.
Experience working with external clients a plus.
Proven ability to think about a problem by skillfully analyzing assessing and reconstructing (financial and nonfinancial) information in order to determine solutions.
Proven ability to effectively lead the management of a multidisciplinary 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
Bachelors degree required; masters degree in related field preferred.
Healthcare background and previous exposure to healthcare policy a plus.
Experience working with external clients a plus.
Proven ability to think about a problem by skillfully analyzing assessing and reconstructing (financial and nonfinancial) information in order to determine solutions.
Proven ability to effectively lead the management of a multidisciplinary 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
Required Experience:
Manager
Employment Type
Full-Time
Key Skills
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