Manager, Payer Strategy & Contracts
Mass General Brigham, Somerville, MA, United States
Job Summary
Mass General Brigham relies on a wide range of professionals, including doctors, nurses, business people, tech experts, researchers, and systems analysts to advance our mission. As a not-for-profit, we support patient care, research, teaching, and community service, striving to provide exceptional care. We believe that high-performing teams drive groundbreaking medical discoveries and invite all applicants to join us and experience what it means to be part of Mass General Brigham.
The role will assist in the development and implementation of an overall strategy for the department to support emerging contractual challenges and opportunities. This position will organize and lead negotiations with health plans and other constituents in conjunction with department leadership. The incumbent will lead the research, organization, development, and assessment of relevant contractual provisions. The position will also develop and present complex decision support materials to multiple audiences.
Essential Functions
Lead the negotiation, execution, and management of payer contracts, including fee-for-service, value-based, and risk-sharing agreements, to achieve optimal reimbursement rates and terms.
Collaborate with legal, finance, and compliance teams to review and finalize contract terms, ensuring they meet regulatory requirements and protect the organization's interests.
Develop and implement payer strategies that support the organization’s financial and operational goals, including network participation, rate negotiation, and payer mix optimization.
Perform financial modeling and analysis to evaluate the impact of proposed contract terms, reimbursement rates, and payment methodologies on revenue and profitability.
Acts as a Subject Matter Expert in regard to the healthcare market for the organization and the Payer Strategy and Contracting group.
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.
Manage multiple projects comprising cross-functional internal teams, including colleagues both at MGB corporate and at the network entities, as well as external constituents.
Staff supervision includes recruitment, professional development, and performance management.
Qualifications Education
Bachelor's Degree Health Administration required or Bachelor's Degree Finance required or Bachelor's Degree Related Field of Study required
Experience
5+ years of experience required in payer contracting, managed care, healthcare finance, or revenue cycle management
2+ years of supervisory or leadership experience required
Knowledge, Skills and Abilities
Strong knowledge of healthcare reimbursement models, payer contracting, and regulatory compliance requirements (e.g., CMS, Medicaid, Medicare).
Proven experience negotiating and managing payer contracts, conducting financial analysis, and developing payer strategies.
Excellent analytical, problem-solving, communication, negotiation, and leadership skills.
Demonstrated project management skills to manage multiple projects and issues simultaneously.
Demonstrate proficiency with a variety of automations, including but not limited to Epic, Excel, PowerPoint, Reporting Databases (POLR), Microsoft Word, and Payer Websites.
Excellent verbal and written communication skills.
Additional Job Details (if applicable) Remote Type Hybrid
Work Location 399 Revolution Drive
Scheduled Weekly Hours 40
Employee Type Regular
Work Shift Day (United States of America)
Pay Range $99,465.60 - $141,804.00/Annual
Grade 8At Mass General Brigham, we believe in recognizing and rewarding the unique value each team member brings to our organization. Our approach to determining base pay is comprehensive, and any offer extended will take into account your skills, relevant experience if applicable, education, certifications and other essential factors. The base pay information provided offers an estimate based on the minimum job qualifications; however, it does not encompass all elements contributing to your total compensation package. In addition to competitive base pay, we offer comprehensive benefits, career advancement opportunities, differentials, premiums and bonuses as applicable and recognition programs designed to celebrate your contributions and support your professional growth. We invite you to apply, and our Talent Acquisition team will provide an overview of your potential compensation and benefits package.
EEO Statement Mass General Brigham Incorporated is an Equal Opportunity Employer. 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. We will ensure that all individuals with a disability are provided a reasonable accommodation to participate in the job application or interview process, to perform essential job functions, and to receive other benefits and privileges of employment. To ensure reasonable accommodation for individuals protected by Section 503 of the Rehabilitation Act of 1973, the Vietnam Veteran’s Readjustment Act of 1974, and Title I of the Americans with Disabilities Act of 1990, applicants who require accommodation in the job application process may contact Human Resources at (857)-282-7642.
Mass General Brigham Competency Framework At Mass General Brigham, our competency framework defines what effective leadership “looks like” by specifying which behaviors are most critical for successful performance at each job level. The framework is comprised of ten competencies (half People-Focused, half Performance-Focused) and are defined by observable and measurable skills and behaviors that contribute to workplace effectiveness and career success. These competencies are used to evaluate performance, make hiring decisions, identify development needs, mobilize employees across our system, and establish a strong talent pipeline.
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The role will assist in the development and implementation of an overall strategy for the department to support emerging contractual challenges and opportunities. This position will organize and lead negotiations with health plans and other constituents in conjunction with department leadership. The incumbent will lead the research, organization, development, and assessment of relevant contractual provisions. The position will also develop and present complex decision support materials to multiple audiences.
Essential Functions
Lead the negotiation, execution, and management of payer contracts, including fee-for-service, value-based, and risk-sharing agreements, to achieve optimal reimbursement rates and terms.
Collaborate with legal, finance, and compliance teams to review and finalize contract terms, ensuring they meet regulatory requirements and protect the organization's interests.
Develop and implement payer strategies that support the organization’s financial and operational goals, including network participation, rate negotiation, and payer mix optimization.
Perform financial modeling and analysis to evaluate the impact of proposed contract terms, reimbursement rates, and payment methodologies on revenue and profitability.
Acts as a Subject Matter Expert in regard to the healthcare market for the organization and the Payer Strategy and Contracting group.
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.
Manage multiple projects comprising cross-functional internal teams, including colleagues both at MGB corporate and at the network entities, as well as external constituents.
Staff supervision includes recruitment, professional development, and performance management.
Qualifications Education
Bachelor's Degree Health Administration required or Bachelor's Degree Finance required or Bachelor's Degree Related Field of Study required
Experience
5+ years of experience required in payer contracting, managed care, healthcare finance, or revenue cycle management
2+ years of supervisory or leadership experience required
Knowledge, Skills and Abilities
Strong knowledge of healthcare reimbursement models, payer contracting, and regulatory compliance requirements (e.g., CMS, Medicaid, Medicare).
Proven experience negotiating and managing payer contracts, conducting financial analysis, and developing payer strategies.
Excellent analytical, problem-solving, communication, negotiation, and leadership skills.
Demonstrated project management skills to manage multiple projects and issues simultaneously.
Demonstrate proficiency with a variety of automations, including but not limited to Epic, Excel, PowerPoint, Reporting Databases (POLR), Microsoft Word, and Payer Websites.
Excellent verbal and written communication skills.
Additional Job Details (if applicable) Remote Type Hybrid
Work Location 399 Revolution Drive
Scheduled Weekly Hours 40
Employee Type Regular
Work Shift Day (United States of America)
Pay Range $99,465.60 - $141,804.00/Annual
Grade 8At Mass General Brigham, we believe in recognizing and rewarding the unique value each team member brings to our organization. Our approach to determining base pay is comprehensive, and any offer extended will take into account your skills, relevant experience if applicable, education, certifications and other essential factors. The base pay information provided offers an estimate based on the minimum job qualifications; however, it does not encompass all elements contributing to your total compensation package. In addition to competitive base pay, we offer comprehensive benefits, career advancement opportunities, differentials, premiums and bonuses as applicable and recognition programs designed to celebrate your contributions and support your professional growth. We invite you to apply, and our Talent Acquisition team will provide an overview of your potential compensation and benefits package.
EEO Statement Mass General Brigham Incorporated is an Equal Opportunity Employer. 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. We will ensure that all individuals with a disability are provided a reasonable accommodation to participate in the job application or interview process, to perform essential job functions, and to receive other benefits and privileges of employment. To ensure reasonable accommodation for individuals protected by Section 503 of the Rehabilitation Act of 1973, the Vietnam Veteran’s Readjustment Act of 1974, and Title I of the Americans with Disabilities Act of 1990, applicants who require accommodation in the job application process may contact Human Resources at (857)-282-7642.
Mass General Brigham Competency Framework At Mass General Brigham, our competency framework defines what effective leadership “looks like” by specifying which behaviors are most critical for successful performance at each job level. The framework is comprised of ten competencies (half People-Focused, half Performance-Focused) and are defined by observable and measurable skills and behaviors that contribute to workplace effectiveness and career success. These competencies are used to evaluate performance, make hiring decisions, identify development needs, mobilize employees across our system, and establish a strong talent pipeline.
#J-18808-Ljbffr