Senior Manager, Network Performance

🕒 Setembro 29

🍂 Massachusetts – Remoto

🍂 Massachusetts – Remote

💵 $133.746 - $200.620 / ano

⏰ Tempo Integral

🟠 Sênior

👔 Gerente

👻 Score fantasma 17%

O que significa: a chance de ninguém estar realmente contratando para esta vaga.Como ler: 60% ou mais significa que achamos que é uma vaga fantasma. Pontuações mais baixas preocupam menos.Por que essa pontuação:

• Aberta há 44 dias.
• As vagas desta empresa costumam ser preenchidas em 28 dias.
• Repostada uma vez.

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Point32Health

SiteLinkedInTodas as Vagas

1001 - 5000 funcionários

🏥 Saúde

🛡️ Seguros

⚕️ Seguro de Saúde

Healthcare • Insurance • Healthcare Insurance

A Point32Health é uma organização líder sem fins lucrativos de saúde e bem-estar que oferece cobertura de saúde e serviços para indivíduos em todas as fases da vida. Através de seu grupo de empresas, incluindo Harvard Pilgrim Health Care e Tufts Health Plan, a Point32Health oferece uma variedade de planos de saúde, programas e serviços que englobam saúde médica, farmacêutica, bem-estar e saúde comportamental. A Point32Health é comprometida com a equidade em saúde e tem sido reconhecida por suas práticas inclusivas, recebendo distinções em áreas como equidade em saúde, inclusão de deficiência e inclusão no local de trabalho LGBTQ+. Com foco em soluções inovadoras e cobertura de alta qualidade, a Point32Health busca criar uma melhor experiência de saúde para seus membros e comunidades.

Descrição

• Lead analytic support for contract negotiations, strategic initiatives, and regulatory requests • Manage staff and provide training and mentoring to team members • Direct complex analysis related to negotiations and provider contracts • Participate in external provider meetings with Contract Managers and Network Contracting staff • Manage data preparation and submission of regulatory requests • Manage analysts in designing and executing complex analyses of provider contracts and payment changes • Coordinate and oversee annual provider network re-contracting for commercial business • Collaborate with Network Contracting, Provider Analytics, Accounting, Trends, and Reserving on provider risk deals • Lead opportunities to improve Point32Health’s financial position through enhanced payment arrangements • Manage development and enhancement of department tools • Coordinate quarterly provider performance assessment reviews • Evaluate and recommend new financial models and processes • Manage network service costing to support Actuarial product pricing • Recruit, train, develop, and evaluate staff • Manage team workload and deliverables • Support Sales RFPs and other duties and projects as needed

🎯 Requisitos

• Experience, skills, education, training, credentials, and experience appropriate to the scope and complexity of the role • Broad, comprehensive knowledge of provider contractual arrangements • Knowledge of value based reimbursement mechanisms • Knowledge of key cost and utilization performance drivers • Ability to manage analysts and staff workload • Ability to design and execute complex analyses measuring financial impact of provider contracts and payment changes • Ability to manage regulatory request submissions • Ability to coordinate annual provider network re-contracting • Ability to develop and enhance department tools • Ability to evaluate and recommend financial models and processes • Ability to manage service costing for network pricing support • Ability to recruit, train, develop, and evaluate staff performance • Ability to support Sales RFPs as appropriate

🏖️ Benefícios

• Medical, dental and vision coverage • Retirement plans • Paid time off • Employer-paid life and disability insurance with additional buy-up coverage options • Tuition program • Well-being benefits • Full suite of benefits to support career development, individual & family health, and financial health • Variable pay eligibility

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