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Senior Manager, Network Operations

2 months ago


Canton, Massachusetts, United States Point32Health Full time
Job Summary

We are seeking a highly skilled Senior Manager to lead our Network Analytics team. The successful candidate will be responsible for managing a team of analysts, providing training and mentoring, and directly supporting complex analysis related to contract negotiations and provider contracts.

Key Responsibilities
  • Lead Team to Analyze Contract Impact

Manage analysts in the design and execution of complex analyses to measure the financial impact of provider contracts and payment changes.

Maintain Comprehensive Knowledge

Maintain a broad, comprehensive knowledge and understanding of provider contractual arrangements, including value-based reimbursement mechanisms and key cost and utilization performance drivers.

Identify Opportunities for Improvement

Proactively lead the team to identify opportunities to improve Point32Health's financial position through enhanced payment arrangements.

Develop Department Tools

Manage the development and enhancement of department tools to aid in standard department work, and work with analytic staff to evaluate and recommend new and innovative financial models and processes.

Participate in External Meetings

Actively participate in external provider meetings with Network Contracting staff as needed.

Oversee Analytics and Compliance

Oversee analytics around network access and adequacy across all lines of business in accordance with compliance and regulatory requirements, and lead analysts in measuring the impact of contracts on network adequacy and access.

Recruit, Train, and Develop Staff

Recruit, train, develop, and evaluate staff performance, and manage the workload of the team, meeting both high-quality standards and customer timelines.

Qualifications
  • Bachelor's Degree Required

A bachelor's degree is required; a master's degree in business administration, health policy, health economics, health services research, management science, medical sociology, or a related field is preferred.

7-10 Years of Experience

7-10 years of experience with 3 years of effective supervisory experience is required.

Proven Ability to Achieve Goals

The successful candidate must have a proven ability to achieve goals and deliver bottom-line results.

Advanced Skills and Knowledge

Advanced Excel skills, SAS/SQL programming, and in-depth knowledge and understanding of managed care concepts and the financial relationship between payers and providers are required.

Leadership and Communication Skills

The candidate must have the ability to lead/mentor a team of staff effectively, meet changing business priorities, think strategically, understand and have insight into healthcare industry issues, and possess strong analytic and technical skills.