Network Contract Leader
About the position
BCBSMA has been a national leader in implementing innovative payment models like the Alternative Quality Contract and pioneering incentives to reduce racial inequities in care. The Contract Leader works closely with the Associate Director of Network Contracting to successfully execute these innovative payment models and quality incentive programs, as well as achieve unit cost trend targets. The Contract Leader 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 Contract Leader is highly curious, analytical, has high attention to detail, and is able to communicate persuasively and effectively, both verbally and in writing.
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.
,
As a member of the team that specializes in Medicare Advantage, provide key negotiation and contracting support for all Medicare Advantage provider contracts and contracting initiatives.
,
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 cross functional negotiation teams.
Requirements
Solid understanding of global, hospital and physician contract development; demonstrated negotiation of complex provider payment arrangements; demonstrated financial, analytical, and modeling abilities; demonstrated understanding of health care reimbursement methods and strategies.
,
Demonstrated ability to influence, negotiate, and operate collaboratively as part of a team.
,
Demonstrated ability to translate and implement multifaceted, ambiguous concepts into concrete, actionable ideas.
,
Excellent written/verbal communication skills; effective presentation skills; project management and planning skills critical.
,
Demonstrated ability to advance initiatives and work independently.
Nice-to-haves
Benefits
Paid time off
,
Medical/dental/vision insurance
,
401(k)
,
Suite of well-being benefits
Apply Now
BCBSMA has been a national leader in implementing innovative payment models like the Alternative Quality Contract and pioneering incentives to reduce racial inequities in care. The Contract Leader works closely with the Associate Director of Network Contracting to successfully execute these innovative payment models and quality incentive programs, as well as achieve unit cost trend targets. The Contract Leader 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 Contract Leader is highly curious, analytical, has high attention to detail, and is able to communicate persuasively and effectively, both verbally and in writing.
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.
,
As a member of the team that specializes in Medicare Advantage, provide key negotiation and contracting support for all Medicare Advantage provider contracts and contracting initiatives.
,
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 cross functional negotiation teams.
Requirements
Solid understanding of global, hospital and physician contract development; demonstrated negotiation of complex provider payment arrangements; demonstrated financial, analytical, and modeling abilities; demonstrated understanding of health care reimbursement methods and strategies.
,
Demonstrated ability to influence, negotiate, and operate collaboratively as part of a team.
,
Demonstrated ability to translate and implement multifaceted, ambiguous concepts into concrete, actionable ideas.
,
Excellent written/verbal communication skills; effective presentation skills; project management and planning skills critical.
,
Demonstrated ability to advance initiatives and work independently.
Nice-to-haves
Benefits
Paid time off
,
Medical/dental/vision insurance
,
401(k)
,
Suite of well-being benefits
Apply Now