Senior Manager, Ancillary Provider Contracting

Who We Are

Point32Health is a leading health and wellbeing organization, delivering an ever-better personalized health care experience to everyone in our communities. At Point32Health, we are building on the quality, nonprofit heritage of our founding organizations, Tufts Health Plan and Harvard Pilgrim Health Care, where we leverage our experience and expertise to help people find their version of healthier living through a broad range of health plans and tools that make navigating health and wellbeing easier.

We enjoy the important work we do every day in service to our members, partners, colleagues and communities. To learn more about who we are at Point32Health, click here (https://youtu.be/S5IHgoecJQ) .

Job Summary

The Sr. Manager of Ancillary Contracting oversees a team of Sr. or Lead Contract Managers, and or Managers in charge of negotiating the most complex Ancillary provider agreements. This individual is the most senior member of the contracting team reporting into the Director of Ancillary Contracting. They will be responsible for providing oversight and assistance to Contract Managers, Associate Contract Managers and Managers regarding the discussion of financial and legal terms. In addition, this individual will ensure that contract terms are consistent with organizational strategy and are negotiated within the organization’s established legal, financial, and operational guidelines. The Sr. Manager, Ancillary Contracting will work closely with the Director, Contracting and the VP of Contracting on negotiation strategy development and execution. Additionally, this individual will work closely with Contract Managers and Associate Contract Managers and the implementation team to ensure smooth, timely, and accurate implementation of all contract terms.

Key Responsibilities/Duties – what you will be doing

Support and coach the Manager, Ancillary Contracting in any personnel and other work-related items.

Ensure the team is supported in the organization of their work, has clearly outlined deliverables, and is performing in an efficient manner.

Support and coach the team in their negotiations maintaining a focus on budgeted targets, regulatory requirements, and operational guardrails.

Work closely with the Contract Managers, Manager, Ancillary Contracting, and legal department to ensure 1) consistency of contract provisions, to the extent possible, across the network and 2) that all relevant provisions are included in the signed agreement.

Assist the Director, Ancillary Contracting in developing the organization’s strategy for their assigned provider specialties and Uphold the strategic position so that Point32Health meets the key objectives that have been identified for the contracting cycle.

Understand, with a high degree of specificity, important business aspects such as value-based contracting, unit cost trend, provider financial performance, and any analytical tools utilized by Point32Health to understand the performance, of the provider network.

Lead and/or participate in cross functional meetings as required; lead internal ad hoc groups to address contracting issues, communicate status of negotiations and document key financial and legal terms.

Supervise and support a team of Sr. Contract Managers, Lead Contract Managers, and Managers direct reports in performing all essential job functions.

Other duties and projects as assigned.

Qualifications – what you need to perform the job

3-5 years in managed healthcare

3-5 years or management experience

Experienced in value-based contract negotiations, including a substantive understanding of provider reimbursement methodologies.

SKILL REQUIREMENTS:

Excellent communication, presentation and influencing skills

Demonstrated strength in finance to support financial contract components and analysis

Ability to research, interpret and communicate complex issues

Ability to coach and lead a team of contract managers and associate contract managers

Advanced analytic ability, mastery of Microsoft Word, Excel and PowerPoint applications

WORKING CONDITIONS AND ADDITIONAL REQUIREMENTS (include special requirements, e.g., lifting, travel) :

Must be able to work under normal office conditions and work from home as required.

Work may require simultaneous use of a telephone/headset and PC/keyboard and sitting for extended durations.

May be required to work additional hours beyond standard work schedule.

The above statements are intended to describe the general nature and level of work being performed by employees assigned to this classification. They are not intended to be construed as an exhaustive list of all responsibilities, duties and skills required of employees assigned to this position. Management retains the discretion to add to or change the duties of the position at any time.

Compensation & Total Rewards Overview

As part of our comprehensive total rewards program, colleagues are also eligible for variable pay. Eligibility for any bonus, commission, benefits, or any other form of compensation and benefits remains in the Companys sole discretion and may be modified at the Company’s sole discretion, consistent with the law.

Point32Health offers their Colleagues 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 with additional buy-up coverage options

Tuition program

Well-being benefits

Full suite of benefits to support career development, individual & family health, and financial health

For more details on our total rewards programs, visit https://www.point32health.org/careers/benefits/

Commitment to Diversity, Equity, Inclusion, Accessibility (DEIA) and Health Equity

​Point32Health is committed to making diversity, equity, inclusion, accessibility and health equity part of everything we do—from product design to the workforce driving that innovation. Our Diversity, Equity, Inclusion, Accessibility (DEIA) and Health Equity teams strategy is deeply connected to our core values and will evolve as the changing nature of work shifts. Programming, events, and an inclusion infrastructure play a role in how we spread cultural awareness, train people leaders on engaging with their teams and provide parameters on how to recruit and retain talented and dynamic talent. We welcome all applicants and qualified individuals, who 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.

Scam Alert : Point32Health has recently become aware of job posting scams where unauthorized individuals posing as Point32Health recruiters have placed job advertisements and reached out to potential candidates. These advertisements or individuals may ask the applicant to make a payment. Point32Health would never ask an applicant to make a payment related to a job application or job offer, or to pay for workplace equipment. If you have any concerns about the legitimacy of a job posting or recruiting contact, you may contact TAoperations@point32health.org

At Point32Health, we strive to be a different kind of nonprofit health and well-being company, with a broad range of health plans, and innovative tools that make navigating health and well-being easier, guiding our members at every step of their health care journey to better health outcomes. We are committed to providing high-quality and affordable health care, improving the health and wellness of our members, and creating healthier communities across the country. The Point32Health name is inspired by the 32 points on a compass. It speaks to the critical role we play in guiding and empowering the people we serve to achieve healthier lives. Our employees are hard-working, innovative, and collaborative. They look for opportunities to grow and make a difference, and they help make us strive to be one of the Top Places to work in New England.