Job Information
Blue Cross Blue Shield of Massachusetts Network Contract Leader in Boston, Massachusetts
Ready to help us transform healthcare? Bring your true colors to blue.
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
Minimum Education Requirements:
High school degree or equivalent required unless otherwise noted above
LocationBostonTime TypeFull time
Salary Range: $102,330.00 - $125,070.00
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 the confidence gap (https://www.theatlantic.com/magazine/archive/2014/05/the-confidence-gap/359815/) and imposter syndrome (https://www.braintreepayments.com/blog/overcoming-imposter-syndrome/) can 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 our Company Culture (https://careers.bluecrossma.org/us/en/culturepage) page. If this sounds like something you’d like to be a part of, we’d love to hear from you. You can also join our Talent Community (https://careers.bluecrossma.org/us/en/jointalentcommunity?applyType=JTC) to 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 (https://careers.bluecrossma.org/us/en/how-we-work) " Page.
Voted as the highest in member satisfaction among Massachusetts commercial health plans by JD Power , Blue Cross Blue Shield of Massachusetts is a community-focused, tax-paying, not-for-profit health plan headquartered in Boston. We have been a market leader for over 75 years, and are consistently ranked among the nation's best health plans. Our daily efforts are dedicated to effectively serving our 2.8 million members, and consistently offering security, stability, and peace of mind to both our members and associates.
Our Commitment to You
We are committed to investing in your development and providing the necessary resources to enable your success. We are dedicated to creating a refreshing and rewarding workplace that promotes excellence and provides opportunities for employees to forge their unique career path. We take pride in our diverse, community-centric, wellness-focused culture and believe every member of our team deserves to enjoy a positive work-life balance.
Blue Cross Blue Shield of Massachusetts is an Equal Employment / Affirmative Action Employer. Applicants are considered for all positions without regard to race, color, religion, sex, national origin, age, veteran status, disability, sexual orientation, gender identity or expression, or any other characteristics protected by law.
Blue Cross Blue Shield of Massachusetts will not discharge or in any other manner discriminate against employees or applicants because they have inquired about, discussed, or disclosed their own pay or the pay of another employee or applicant. However, employees who have access to the compensation information of other employees or applicants as a part of their essential job functions cannot disclose the pay of other employees or applicants to individuals who do not otherwise have access to compensation information, unless the disclosure is (a) in response to a formal complaint or charge, (b) in furtherance of an investigation, proceeding, hearing, or action, including an investigation conducted by the employer, or (c) consistent with Blue Cross Blue Shield of Massachusetts's legal duty to furnish information.