Job Details

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Point32Health is a leading not-for-profit health and well-being organization dedicated to delivering high-quality, affordable healthcare. Serving nearly 2 million members, Point32Health builds on the legacy of Harvard Pilgrim Health Care and Tufts Health Plan to provide access to care and empower healthier lives for everyone.

The Director of Contracting is responsible for contract strategy, development, negotiation, and implementation for hospitals, physician groups, and integrated delivery systems across multiple markets and products. The Director will lead a team who negotiates contracts including risk arrangements to enable high performing provider networks that support goals for membership growth, quality, and financial performance.

Job Description

Key Responsibilities/Duties:

• Develop provider networks to meet goals for access, membership, quality, medical cost, and earnings.
• Collaborate with VP and President to develop network strategies, risk sharing and payment models, and performance incentives to support achievement of cost and quality goals.
• Stay abreast of trends and changes in the industry, provider landscape, and federal and state payment policies and methodologies.

Contract Negotiation and Management:

• Direct a team of contract managers to negotiate financial, operational, regulatory, and legal contract parameters with physician groups, ACOs, and hospitals to meet business goals and regulatory timelines.
• Coach, support, and train staff to devise proposals, strategies, and options for contract negotiation.
• Devise strategy, lead and negotiate agreements with largest provider systems.

Qualifications:

• Required (minimum): bachelor's degree in business, health care or related field.
• Preferred: Master's degree
• Required (minimum): 10-15 years of progressively responsible management experience in a complex healthcare setting.
• Preferred: 10-15 years of Medicare Advantage experience.

Skill Requirements:

• Energetic, goal driven leader with a proven ability to deliver results and lead teams to achieve goals.
• Strong working knowledge of managed care/risk contracting payment methodologies.
• Savvy negotiator with experience in a range of provider payment methodologies including risk.

We welcome all applicants and will receive consideration for employment without regard to race, color, religion, gender, gender identity or expression, sexual orientation, national origin, genetics, disability, age, or veteran status.

Point32Health offers a competitive and comprehensive total rewards package which currently includes: medical, dental and vision coverage, retirement plans, paid time off, employer-paid life and disability insurance, tuition program, well-being benefits, and more.