Senior Contract Negotiator

5 days ago

Canton, Massachusetts, United States Ignyte AI Full time
Job Description

Job Summary:

The Senior Contract Negotiator will support all Lines of Business, including Commercial, Senior Products and Public Plans. The Senior Contract Negotiator will serve as the primary point of contact to manage contract negotiations with integrated health delivery systems, hospitals, local care units, physician practices, federally qualified health centers/community health centers, select ancillary providers and other providers as required.

Key Responsibilities:

  • Negotiate contractual arrangements with established and/or potential network providers, within budgeted targets, with approved contract guidelines and regulatory requirements.
  • Lead meetings between Point32Health and our provider network, while effectively articulating Point32Health's position on key issues relevant to the contract negotiation. Manage and position the negotiation so that Point32Health meets the key objectives that have been identified for the contracting cycle.
  • Work closely with internal finance and actuarial teams, while providing direction to ensure data analytics and modeling are produced to support contract negotiations.
  • Develop contract documentation, clearly specifying terms, including legal, regulatory, policy, financial and others thus allowing for implementation of the contract and minimizing/preventing internal/external misunderstandings of contract intent.
  • Work closely with legal and compliance departments to ensure contract provisions are consistent across providers and ensure applicable legal and regulatory terms are included in the signed contract.
  • Manage and position the negotiation so that Point32Health meets the key objectives that have been identified for the contracting cycle.
  • Develop and maintain effective working relationships with key counterparts representing the provider and key internal colleagues to allow for support of Point32Health initiatives.
  • Understand, with a high degree of specificity, important business aspects such as unit cost trend, alternative payment methodologies, risk arrangements such as trend-based risk and percent of premium arrangements, medical loss ratio, provider financial performance, and any analytical tools utilized by Point32Health to understand the performance, financial and otherwise, of the provider network. The Senior Contract Negotiator must be well versed in publicly reported financial data, such as provider relative price and total medical expense, for use in negotiations.
  • Lead and/or participate in cross functional meetings as required - lead internal ad hoc groups to address contracting issues, communicate status of negotiations and document key financial and legal terms.
  • As required, support submissions to government agencies specific to your Market.
  • Develop and maintain relationships with key providers supporting financial, clinical, sales, retention, and quality goals. Participate as required in interdisciplinary teams engaged with key providers.
  • Be aware of network adequacy requirements for all Lines of Business and work to ensure adequacy and competitiveness in all provider networks.
  • Represent and speak for Network Contracting assigned Market, including with regional leadership, sales, clinical, marketing and administrative colleagues, as well as with trade associations and regulatory agencies as required.
  • Other duties as assigned.

Qualifications:

  • Bachelor's Degree or equivalent experience.
  • 5-7 years' work experience, preferred in managed care or other health care environment, with knowledge of the health care market and needs/concerns of the industry
  • Direct contract negotiation for multiple lines of business and products is desirable. Understanding of provider payment methodologies and experience with risk based financial models.
  • Must be initiative-taking individual with excellent organizational skills to manage large volumes of information and multiple assignments; attention to detail is key.
  • Ability to understand and interpret the various aspects of a contract - financial, legal, and operational with emphasis on implementation of contract terms.
  • Possess strong customer focus and expertise in setting and managing customer expectations.
  • Ability to understand the nuances of various product lines and the unique operational and financial features associated with each product.
  • Requires initiative, sound judgment, and ability to work independently under pressure in a constantly changing environment balancing multiple priorities.
  • Ability to learn and apply Point32Health Plan's policies consistently and seek guidance when necessary.
  • Conceptualize and envision the impact of change and seek out efficiencies at work. Must be flexible and a proponent/champion of change.
  • Excellent people skills to develop strong working relationships with internal and external contacts.
  • Requires excellent diplomacy, oral and written communication skills as well as the ability to coordinate efforts among various departments at Point32Health.
  • Ability to research, interpret and communicate complex issues in a clear and succinct manner.
  • Advanced analytic ability with proficiency in Microsoft Word, Excel, and PowerPoint applications.
  • Must be able to work cooperatively as a team member.

  • Senior Contract Manager

    4 hours ago

    Canton, Massachusetts, United States Point32Health Full time

    About the RoleWe are seeking a highly skilled Senior Contract Manager to join our team at Point32Health. As a key member of our organization, you will play a critical role in negotiating and managing contracts with healthcare providers, ensuring that our company's interests are protected while maintaining strong relationships with our partners.Key...

  • Senior Contract Manager

    3 days ago

    Canton, Massachusetts, United States Point32Health Full time

    About the RoleWe are seeking a highly skilled Senior Contract Manager to join our team at Point32Health. As a key member of our organization, you will play a critical role in negotiating and managing contracts with healthcare providers, ensuring that our company's interests are protected while maintaining strong relationships with our partners.Key...

  • Senior Manager, Network Operations

    5 days ago

    Canton, Massachusetts, United States Ignyte AI Full time

    Job SummaryWe are seeking a highly skilled Senior Manager to lead our Network Analytics team. As a key member of our organization, you will be responsible for providing strategic support to our contract negotiations, strategic initiatives, and regulatory requests.Key ResponsibilitiesLead Complex Analyses: Manage analysts in the design and execution of...

  • Senior Manager, Network Operations

    3 days ago

    Canton, Massachusetts, United States Point32Health Full time

    Job SummaryWe 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 ResponsibilitiesLead Team to Analyze Contract...

  • Senior Sustaining Engineer

    2 weeks ago

    Canton, Massachusetts, United States netPolarity, Inc. (Saicon Consultants, Inc.) Full time

    Position: Senior Sustaining EngineerLocation: Canton, MAContract Duration: 5+ months with potential for extensionKey Qualifications:Bachelor's degree in engineering or equivalent experience, along with 3-5 years of relevant industry experience.Proficient in Microsoft Office Suite.Ability to collaborate effectively with a team of engineers to develop suitable...

  • Senior Program Manager

    6 days ago

    Canton, Massachusetts, United States Point32Health Full time

    Job SummaryThe Senior Program Manager will be responsible for the development, implementation, and management of complex programs and initiatives, including annual and ad hoc programs, initiatives, and projects associated with multiple business lines and may involve state and federal regulations.Key ResponsibilitiesOverall program ownership and management of...

  • Senior Electrical Project Coordinator

    1 week ago

    Canton, Massachusetts, United States Jobot Full time

    Electrical Project Delivery ManagerThis position offers an exciting opportunity to join a forward-thinking electrical contracting firm recognized for its outstanding workplace culture. The organization focuses on providing exceptional services to top-tier corporations, property management entities, and leading general contractors, and is currently...

  • DOD Engineering Project Manager

    5 days ago

    Canton, Massachusetts, United States APTIM Full time

    About the RoleWe are seeking a highly skilled and experienced DOD Engineering Project Manager to join our team at APTIM. As a key member of our project management team, you will be responsible for leading and managing complex engineering design projects for Department of Defense locations worldwide.Key ResponsibilitiesProvide management and oversight of DOD...

  • Client Relationship Manager

    2 weeks ago

    Canton, Massachusetts, United States Ignyte AI Full time

    Job OverviewPosition SummaryThis position is responsible for cultivating and sustaining robust connections with clients, brokers, and consultants at Ignyte AI. The focus is on strategic account management to enhance client retention, boost membership, achieve revenue targets, and introduce innovative products and services as needed. This is achieved through...

  • Project Director

    5 days ago

    Canton, Massachusetts, United States Professional Electrical Contractors of CT, Inc. Full time

    Job Summary**Job Title:** Project Manager**Job Summary:** We are seeking a highly skilled and experienced Project Manager to join our team at Professional Electrical Contractors of CT, Inc. The successful candidate will be responsible for overseeing the day-to-day management of Assistant Project Managers and projects assigned to them.Key...

  • Real Estate Project Coordinator

    3 days ago

    Canton, Massachusetts, United States Boston Hire Full time

    Job SummaryBoston Hire is seeking a highly organized and detail-oriented Project Assistant to support our residential real estate development team. As a Project Assistant, you will play a critical role in ensuring the successful delivery of projects from inception to completion.Key Responsibilities:Project Planning and Coordination: Assist in the development...

  • Renewable Energy Cost Estimator

    1 week ago

    Canton, Massachusetts, United States North American Renewables Full time

    Job OverviewNorth American Renewables is in search of a skilled Estimator to enhance our expanding Solar EPC division. The ideal candidate will demonstrate the expertise, experience, and assurance to engage effectively with design professionals, consultants, and clients, maintaining a strong customer-centric approach. Our team is committed to excellence and...

  • Renewable Energy Cost Estimator

    1 week ago

    Canton, Massachusetts, United States North American Renewables Full time

    Job OverviewNorth American Renewables is in search of a skilled Estimator to enhance our expanding Solar EPC division. The ideal candidate will have the expertise, experience, and assurance to effectively collaborate with design professionals, consultants, and clients, all while maintaining a strong customer-centric approach. Our team is committed to...

  • Cost Estimator

    2 weeks ago

    Canton, Massachusetts, United States North American Renewables Full time

    Job OverviewNorth American Renewables is in search of a Cost Estimator specializing in renewable energy projects. The ideal candidate will have the expertise and assurance to effectively engage with design professionals, consultants, and clients, maintaining a strong customer-centric approach. Our team is committed to excellence and fulfilling our promises...

  • Lead Sustaining Engineer

    2 weeks ago

    Canton, Massachusetts, United States netPolarity, Inc. (Saicon Consultants, Inc.) Full time

    Position: Senior Reliability EngineerLocation: Canton, MAContract Duration: 5+ months with potential for extensionEssential Qualifications:Bachelor's degree in engineering or a related field, accompanied by 3-5 years of relevant industry experience.Proficient in Microsoft Office Suite.Skilled in collaborating with engineering teams to develop effective...

  • Environmental Sustainability Specialist

    5 days ago

    Canton, Massachusetts, United States APTIM Full time

    About the RoleWe are seeking a highly motivated and detail-oriented Environmental Engineer to join our team at APTIM. As an Environmental Engineer, you will play a critical role in supporting our various Federal contracts and contributing to the success of our environmental services.Key ResponsibilitiesApply engineering skills and knowledge to complete...

  • Sales Operations Coordinator

    2 weeks ago

    Canton, Massachusetts, United States Robert Reiser & Co, Inc. Full time

    Job OverviewWe are seeking a detail-oriented and proactive Sales Support Administrator to assist our Sales Division at Robert Reiser & Co, Inc., which specializes in providing advanced food processing and packaging solutions to various food manufacturing facilities across the nation.Key Responsibilities:Efficiently transcribe dictated correspondence and...

  • Strategic Program Manager

    5 days ago

    Canton, Massachusetts, United States Ignyte AI Full time

    Job DescriptionJob Summary:The Strategic Program Manager is responsible for the successful delivery of new capabilities via the successful management and delivery of cross-functional, large-scale, and complex programs intended to either reduce organizational risk or maximize strategic opportunities. These programs are frequently multi-year, with the highest...

  • Technical Support Specialist

    2 weeks ago

    Canton, Massachusetts, United States Westinghouse Electric Company Full time

    IT Help Desk Analyst - Contract to PermanentLocation: RemoteAre you ready to contribute to a forward-thinking organization that is dedicated to providing sustainable energy solutions? At Westinghouse Electric Company, we understand that our workforce is our greatest asset. We are committed to attracting and retaining top talent while fostering an inclusive...

  • Lead Financial Planning Analyst

    2 weeks ago

    Canton, Massachusetts, United States Point32Health Full time

    About UsPoint32Health is a prominent organization in the health and wellness sector, dedicated to providing a personalized healthcare experience to all individuals in our communities. We are building on the strong, nonprofit legacy of our founding organizations, Tufts Health Plan and Harvard Pilgrim Health Care, utilizing our extensive experience to assist...