As a not-for-profit organization, Mass General Brigham is committed to supporting patient care, research, teaching, and service to the community by leading innovation across our system. Founded by Brigham and Women's Hospital and Massachusetts General Hospital, Mass General Brigham supports a complete continuum of care including community and specialty hospitals, a managed care organization, a physician network, community health centers, home care and other health-related entities. Several of our hospitals are teaching affiliates of Harvard Medical School, and our system is a national leader in biomedical research.
We're focused on a people-first culture for our system's patients and our professional family. That's why we provide our employees with more ways to achieve their potential. Mass General Brigham is committed to aligning our employees' personal aspirations with projects that match their capabilities and creating a culture that empowers our managers to become trusted mentors. We support each member of our team to own their personal development-and we recognize success at every step.
Our employees use the Mass General Brigham values to govern decisions, actions and behaviors. These values guide how we get our work done: Patients, Affordability, Accountability & Service Commitment, Decisiveness, Innovation & Thoughtful Risk; and how we treat each other: Diversity & Inclusion, Integrity & Respect, Learning, Continuous Improvement & Personal Growth, Teamwork & Collaboration.
GENERAL SUMMARY/OVERVIEW STATEMENT:
The Payer Strategy and Contracting group is seeking a candidate with an in-depth understanding of a broad range of health policy issues facing Mass General Brigham and advanced knowledge of the health care market. The Payer Strategy and Contracting group evaluates key health policy, healthcare payment, and healthcare market issues in the context of Mass General Brigham relations with commercial payers, Medicare, and Medicaid. The group is responsible for implementing key policy positions through the negotiation and management of contracts with health insurance plans and third-party payers on behalf of Mass General Brigham's providers. Examples of policy issues include:
• Payment and reimbursement issues • Payment reform and alternative payment models • Healthcare reform • Pay-for-performance quality incentive programs • Provider network development • New care models such as patient-centered medical homes, urgent care, and telehealth • Price transparency • Accountable care organization progress and development • Medical cost trend management
The Manager will participate with department leadership in the development and implementation of an overall strategy that addresses emerging contractual issues and opportunities that may result from changes in payment models, payment policies, regulations, and other business operations. Specifically, the Manager will lead the research, organization, and assessment of relevant contractual provisions; develop and present complex decision support materials for a variety of audiences (including senior leadership); organize and lead negotiations with health plans and other constituents in conjunction with department leadership; develop clear and concise written materials (project plans, presentations, decision documents, proposals, and contract documents), and thinking critically about the implications of contract provisions on Mass General Brigham's operations.
The Manager must have the ability to think independently, critically, strategically, broadly, and creatively; possess exceptional organizational and project management skills; have excellent written and verbal communication skills; can assess, understand, and integrate financial and other data; and can lead a multi-disciplinary group of internal constituents in a matrix environment.
PRINCIPAL DUTIES AND RESPONSIBILITIES:
Possess and continuously develop extensive knowledge of the healthcare market, including facts, concepts, and trends that are general to the industry as well as specific to Partners and the Payer Strategy and Contracting group.
Manage multiple projects comprising cross-functional internal teams (including Contracting, Contract Finance, Mass General Brigham Population Health Management, General Counsel, Business Planning, Government Payment Policy, Government Relations, Community Health, and other specific entities) as well as external constituents.
Build and continuously foster relationships with internal and external counterparts and other key stakeholders.
Identify, research, and organize key information required for contract negotiations; and, in conjunction with department leadership, develop negotiating strategy and tactics and organize and lead external contract negotiations.
Develop and present complex presentation materials (incorporating financial terms) for a variety of audiences including senior leadership.
Proactively lead (in conjunction/collaboration with various constituents) the generation of key questions, analytics, options for consideration, risks/opportunities, best practices, and ultimately recommendations for decision support.
Develop written proposals for contract negotiations and complex contract language to reflect negotiated agreements, considering potential implications across the organization.
Interpret contract language and respond to questions from internal and external constituents.
Staff supervision include: recruitment, professional development, and performance management.
Assist in the oversight and prioritization of work assignments, monitor the quality and accuracy of deliverables and ensure timely delivery of projects.
Other responsibilities as assigned.
Bachelor's degree required (Masters preferable) in related fields such as business, health care administration, health care management, finance or law.
Healthcare background and previous exposure to healthcare policy a plus.
Experience working with external clients a plus.
Skills, Abilities and Competencies
Proven ability to think about a problem by skillfully analyzing, assessing and reconstructing (financial and non-financial) information in order to determine solutions.
Proven ability to effectively lead the management of a multi-disciplinary project.
Proven ability to work with and present concepts to a wide range of audiences.
Proven ability to effectively communicate both verbally and in writing.
Ability to design, develop, interpret, and synthesize financial data/analysis and contractual provisions, and to communicate about them both verbally and in writing.
Familiarity with financial analytics and some ability to manipulate data in MS Excel.
MS PowerPoint knowledge a plus
EEO Statement Mass General Brigham is an Equal Opportunity Employer & by embracing diverse skills, perspectives and ideas, we choose to lead. All qualified applicants will receive consideration for employment without regard to race, color, religious creed, national origin, sex, age, gender identity, disability, sexual orientation, military service, genetic information, and/or other status protected under law.
Partners Healthcare System Inc. is acting as an Employment Agency in relation to this vacancy.
Internal Number: 3137512-1435_1607634255
About MGH Institute of Health Professions
MGH Institute of Health Professions, founded by Massachusetts General Hospital in 1977, is an innovative and independent graduate school in Boston that is a member of Partners HealthCare. A progressive leader in developing comprehensive models of health care education, the MGH Institute prepares advanced practice professionals in the fields of nursing, physical therapy, occupational therapy and communication sciences and disorders through a distinctive combination of academic study, clinical practice, and research. More than 1,200 students are enrolled in graduate level and certificate programs, with an increasing number of courses available online. The Institute is accredited by the New England Association of Schools and Colleges (NEASC).