Senior Manager, Network Performance

This is a fully remote position, open to applicants in Massachusetts.

📋 Description

• Provide analytic leadership for contract negotiations, strategic initiatives, and regulatory submissions.

• Supervise analysts in the design and execution of intricate analyses that assess the financial effects of provider contracts and payment modifications.

• Keep up-to-date with provider contractual agreements, value-based reimbursement strategies, and cost and utilization factors.

• Submit requests for regulatory compliance.

• Oversee and manage the annual re-contracting process for the provider network in commercial sectors.

• Collaborate with teams in Network Contracting, Provider Analytics, Accounting, Trends, and Reserving on provider risk agreements.

• Spot opportunities to enhance Point32Health’s financial standing through improved payment arrangements.

• Oversee the development and refinement of departmental tools.

• Organize quarterly evaluations of provider performance assessments.

• Engage in external provider meetings alongside Network Contracting personnel.

• Manage service costing for network product pricing to assist Actuarial functions.

• Recruit, train, mentor, and assess team members.

• Oversee team workload and project timelines.

• Support Sales RFPs as needed.

• Undertake additional duties and projects as required.

⛳️ Requirements

• Extensive and thorough understanding of provider contractual agreements.

• Familiarity with value-based reimbursement models and significant cost and utilization performance drivers.

• Proven experience in conducting complex analyses related to negotiations and provider contracts.

• Demonstrated experience in managing personnel and providing training and mentorship.

• Competence in preparing data for regulatory requests.

• Ability to coordinate the annual re-contracting process of the provider network.

• Capacity to collaborate with Network Contracting, Provider Analytics, Accounting, Trends, and Reserving teams.

• Skill in evaluating and proposing innovative financial models and processes.

• Proficiency in managing service costs for network product pricing.

• Capability to recruit, train, guide, and assess staff performance.

• Ability to handle workload effectively while adhering to quality standards and meeting client timelines.

🏝️ Benefits

• Medical, dental, and vision insurance.

• Retirement plans.

• Paid time off.

• Employer-funded life and disability insurance with options for additional coverage.

• Tuition assistance program.

• Well-being benefits.

• Comprehensive benefits package to support career development, health for individuals and families, and financial well-being.

• Eligibility for variable pay.