Manager, Ancillary Provider Contracting

Manager, Ancillary Provider Contracting Company Overview

Point
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Health is a leading not‑for‑profit health and well‑being organization dedicated to delivering high‑quality, affordable healthcare. Serving nearly 2 million members, Point
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Health builds on the legacy of Harvard Pilgrim Health Care and Tufts Health Plan to provide access to care and empower healthier lives for everyone. Our culture revolves around being a community of care and having shared values that guide our behaviors and decisions. We’ve had a long‑standing commitment to inclusion and equal healthcare access and outcomes, regardless of background; it’s at the core of who we are.

We value the rich mix of backgrounds, perspectives, and experiences of all of our colleagues, which helps us to provide service with empathy and better understand and meet the needs of the communities where we serve, live, and work.

The Manager of Allied Health Contracting oversees a team of Contract Managers, Associate Contract Managers, or other staff as appropriate who negotiate with allied health providers. This individual may lead the management of certain allied contracts and assist team members during negotiations by providing oversight and assistance with the financial and legal terms. The Manager works closely with the Director of Allied Health Contracting and Vice President as applicable on negotiation strategy development and execution.

Additionally, this individual will work closely with contract management staff on day‑to‑day negotiations and implementations to ensure smooth and timely transitions of key contract elements.

• Supervise and support the contract management team’s negotiations of contractual arrangements with established or potential network providers, within budgeted targets and regulatory requirements. Oversee accurate and complete analytic requests to support contract negotiations and the development of contract documents. Participate as lead in negotiations when appropriate and directly manage high‑cost, high‑volume contracts.
• Understand with high specificity the important business aspects such as budget models, unit cost trends, and other analytics used to evaluate the allied provider network’s performance.
• Oversee the staff of Allied Health Contract Managers and Associate Contract Managers, providing coaching, feedback, and direction to allow team members to develop subject‑matter expertise and independently manage their assigned ancillary service lines.
• Assist contract management staff and Director in developing Point
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  Health’s position on key negotiation issues. Manage and position the negotiation so that Point
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  Health meets the key objectives identified; communicate status and document key financial and legal terms.
• Lead and/or participate in cross‑functional meetings as required; lead internal ad‑hoc discussions to address contracting issues.
• Other duties and projects as assigned.

• Bachelor’s degree (required)
• Master’s degree (preferred)

• 5–7 years of professional experience (required)
• 8–10 years of experience in contract negotiations, including familiarity with payment methodologies (preferred)

• Contract negotiation experience with the ability to understand and interpret all aspects of a contract: financial, legal, and operational, with emphasis on implementation of contract terms.
• Demonstrated strength in finance to support financial contract components and analysis.
• Ability to research, interpret, and communicate complex issues.
• Ability to understand the nuances of Tufts Health Plan’s commercial and Medicare Preferred product lines and the unique operational and financial features associated with each.
• Ability to maintain effective and productive staff/management relationships, including motivating staff by fostering team spirit, a cooperative attitude, and commitment to the organization.
• Advanced analytic ability with proficiency in Microsoft Word, Excel, and PowerPoint applications.

• Must be able to work under normal office conditions and work from home as required.
• Work may require simultaneous use of a…