Supply Chain - Baystate Health
Category(s): Finance, Supply Chain
Full Time / Part Time: Full-Time
This is a remote position for MA, FL, TN, NH, NC, Ohio, Texas, Kansas, MI, VT, CT, MO, RI residents
Baystate Health, western Massachusetts’s premier healthcare provider, and home to Baycare Health Partners a Provider Hospital Organization (PHO) serving the four Baystate hospitals and close to 140 medical practices throughout the Pioneer Valley of Western Massachusetts is seeking a Manager of Managed Care Contract.
Manager of Managed Care Contract – Position Priorities
The Manager of Managed Care Contract position will be responsible for a wide variety of duties related to the development, implementation, and ongoing management of the Baystate Health (BH) & Baycare Health Partners (BHP) managed care contracting function. The BH & BHP contracts contribute to the overall mission, vision and strategy of BH with a focus on the IHI triple aim initiative. Primary responsibilities include contract administration, review and analysis of contract proposals, development of managed care strategies, and a liaison role to both external and internal customers and other special projects.
Assist in the development of an overall strategy for the managed care activities for BH and BHP. Review contract language, rate and fee proposals, complete market analysis comparisons and evaluate proposal and present to BH & BHP senior leadership and membership
Participate, develop, maintain and communicate alternative payment methodologies (risk sharing, shared savings, bundle & global payment arrangements, pay for performance programs, etc.)
Act as a liaison to internal BH & BHP customers, BHP member committees (Board, CAC, CIAC, R&R and PMAG), and external partners (payer contracting and provider relations management)
Disseminate and understand healthcare market and industry changes including impacts due to Affordable Care Act, Massachusetts Health Exchange and regulatory requirements and communicate the impact of these changes to the BH & BHP partners
Provide supervision and mentoring of respective managed care staff (Senior Contract Administrator & Contract Administrator Associate positions)
Follow-up and address with payers global contracting issues encountered by practices/members. Ensure and interpret payer compliance to contract language and provisions and follow-up on any issues as appropriate
Develop, review and communicate operational and clinical requirements. Assist with pay for performance and bonus program settlement and distribution process
Required Work Experience:
5 years Healthcare, Managed Cared, Payer expertise
Preferred Work Experience:
PHO, ACO, Provider focus or experience
Skills and Competencies:
Excellent communication and presentation skills, financial acumen, relationship building, knowledge of antitrust laws and regulations, ability to tactfully navigate healthcare environment with various key parties
You Belong At Baystate
At Baystate Health we know that treating one another with dignity and equity is what elevates respect for our patients and staff. It makes us not just an organization, but also a community where you belong. It is how we advance the care and enhance the lives of all people.
DIVERSE TEAMS. DIVERSE PATIENTS. DIVERSE LOCATIONS.
Bachelor of Science (Required), Master of Arts
Equal Employment Opportunity Employer
Baystate Health is an Equal Opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, marital status, national origin, ancestry, age, genetic information, disability, or protected veteran status.