Director, Hospital and Physician Group Contracting Job in Quincy, Massachusetts Us
Who we are
Harvard Pilgrim is a not-for-profit health plan and a full-service benefits company serving members in Massachusetts, New Hampshire, Maine and beyond. We make health care work better. We recognize diversity's impact and importance for our workforce, customers and providers, and through our contributions to the communities we serve. It's part of the way we do business.
What we value
Harvard Pilgrim believes that greatness is built from the inside out. It's created by individuals who share common goals, and who support and rely on one another to achieve them. Our core values guide us in how we treat, respond to and interact with our customers, business partners and one another.
Who we hire
We hire the best and brightest-talented individuals who value innovation, creativity and communication in the workplace. Harvard Pilgrim believes that by attracting, retaining and engaging diversetalent, we gain a sustained competitive advantage for continued growth.
Our employees bring Harvard Pilgrim's mission, values and brand to life in an inclusive and supportive environment where they are respected and valued for their contributions. Being part of the Harvard Pilgrim team means that you excel at what you do. You're dedicated to your work and continually look for new ways to serve your customers better.
What we offer
We do our best to support our employees in making the most of their lives both inside and outside of work. At Harvard Pilgrim, we know that a talented, engaged and inclusive workforce is our greatest strength. We have an excellent benefit package and are "T" accessible.Some of our benefits include:
* A comprehensive work and life benefits program, including medical and dental benefits, time away from work, retirement, financial protection and on-site fitness centers.
* Opportunities to learn and grow, build relationships, share your opinions and do what you do best every day.
* Ways to serve and give back to the communities where you live, work and play - through grants, fundraising and volunteering.
JOB SUMMARY:
The Director of Hospital and Physician Group Contracting is responsible, under the oversight of the Director, Provider Network Services, for providing leadership and direction in the contracting and business relationships of HPHCs hospital and physician contracts. The Director is also responsible for providing support and direction for financial and term strategies related to third-party vendor agreements where certain managed care organization services are outsourced (e.g. behavioral health, radiology management and specific disease management services).
Essential Functions:
- Responsible for ensuring that provider network contracts are maintained at the optimum cost and benefit to the organization within budget and sales and marketing requirements for all products.
- Along with key internal constituents, contribute substantially to the development and implementation of provider network contract models and reimbursement methodologies.
- Responsible for ensuring that contracts and supporting documentation are compliant with legal and regulatory requirements, completed within Leadership determined timelines and that contract terms are accurately articulated for implementation purposes.
- Responsible for coordinating Harvard Pilgrim business interests with other areas within the Health Services business unit relative to relationships with provider community.
- Responsible for ensuring appropriate coordination with Provider Support functions, Claims Services, and other areas of provider operations.
- Responsible for serving on cross-functional groups and steering committees associated with key corporate business goals and projects, including product development and implementation initiatives, medical cost savings initiatives, administrative service initiatives, etc.
- Responsible for leading the development and implementation of contracting strategy and tactics for new or modified vendor agreements.
- Recruit, hire, coach and manage staff within this department.
- Provide overall direction to staff in the department to carry out corporate and department goals and objectives.
- Ensure appropriate training of staff in both contracting and network management skills as well as general development areas.
- Focus on staff engagement and development and foster teamwork within the department.
- Promote collaboration with other departments across the organization.
- BA/BS Degree, Masters Degree preferred
- 7 to 10 years progressively responsible experience in related fields
- Proven ability to successfully negotiate high dollar complex contracts with independence
- Proven ability to manage multiple projects and staff, and experience as decision-maker and leader around high-level corporate priorities
- Superior analytical skills, communication skills, management skills, interpersonal and leadership skills
- Excellent organizational skills
- Ability to work in demanding environment with result oriented, disciplined focus.
- Broad working knowledge of managed care industry and business environment
- Demonstrated Work Ethic
If you'd like to join Harvard Pilgrim, we'd like to hear from you!
Please visit www.harvardpilgrim.org to set up a job agent.
Harvard Pilgrim supports individuals in reaching their full potential by supporting equal employment opportunities and an environment that actively values diversity and inclusion. Harvard Pilgrim complies with all applicable laws concerning hiring and employment practices and is firmly committed to fostering and maintaining a workplace free from discrimination. We pledge to hire, train, and promote our employees without regard to race, religion, gender, gender identity, age, national origin, sexual orientation, disability, veteran status or any other category protected by applicable law.
