Network Contract Leader

What We Need:

BCBSMA has been a national leader in implementing innovative payment models like the Alternative Quality Contract and most recently announced our intent to collaborate with providers to develop incentives to reduce racial inequities in care. The Contract Leader works closely with the 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 analytical, has high attention to detail, and is able to communicate persuasively and effectively, both verbally and in writing.

This position is eligible for our FLEX persona.

Day-to-Day:

• 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.
• 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.

Qualifications (Knowledge, Skills and Abilities)

• 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.
• Excellent written/verbal communication skills; effective presentation skills; project management and planning skills critical.
• Demonstrated ability to advance initiatives and work independently.

Education/Relevant Experience:

• BS/BA required; Masters preferred
• 5+ years demonstrated health care finance or policy experience, with 3+ years provider or payer contracting and negotiation experience preferred.

#LI-Hybrid

High school degree or equivalent required unless otherwise noted above

The job posting range is the lowest to highest salary we in good faith believe we would pay for this role at the time of this posting. We may ultimately pay more or less than the posted range, and the range may be modified in the future. An employee's pay position within the salary range will be based on several factors including, but limited to, relevant education, qualifications, certifications, experience, skills, performance, shift, travel requirements, sales or revenue-based metrics, and business or organizational needs and affordability.

This job is also eligible for variable pay.

We offer comprehensive package of benefits including paid time off, medical/dental/vision insurance, 401(k), and a suite of well-being benefits to eligible employees.

Note: No amount of pay is considered to be wages or compensation until such amount is earned, vested, and determinable. The amount and availability of any bonus, commission, or any other form of compensation that are allocable to a particular employee remains in the Company's sole discretion unless and until paid and may be modified at the Company's sole discretion, consistent with the law.

WHY Blue Cross Blue Shield of MA?

We understand that theconfidence gapandimposter syndromecan prevent amazing candidates coming our way, so please don't hesitate to apply. We'd love to hear from you. You might be just what we need for this role or possibly another one at Blue Cross Blue Shield of MA. The more voices we have represented and amplified in our business, the more we will all thrive, contribute, and be brilliant. We encourage you to bring us your true colors, , your perspectives, and your experiences. It's in our differences that we will remain relentless in our pursuit to transform healthcare for ALL.

As an employer, we are committed to investing in your development and providing the necessary resources to enable your success. Learn how we are dedicated to creating an inclusive and rewarding workplace that promotes excellence and provides opportunities for employees to forge their unique career path by visiting ourCompany Culturepage. If this sounds like something you'd like to be a part of, we'd love to hear from you. You can also join ourTalent Communityto stay "in the know" on all things Blue.

At Blue Cross Blue Shield of Massachusetts, we believe in wellness and that work/life balance is a key part of associate wellbeing. For more information on how we work and support that work/life balance visit our "How We Work" Page.