Sr Network Consultant
Point32HealthAbout the role
Who We Are
Point32Health is a leading health and wellbeing organization, delivering an ever-better personalized health care experience to everyone in our communities. At Point32Health, we are building on the quality, nonprofit heritage of our founding organizations, Tufts Health Plan and Harvard Pilgrim Health Care, where we leverage our experience and expertise to help people find their version of healthier living through a broad range of health plans and tools that make navigating health and wellbeing easier.
We enjoy the important work we do every day in service to our members, partners, colleagues and communities. To learn more about who we are at Point32Health, click here.
Job Summary
Reporting to the VP of Contracting, this role will be a strategic partner from Contracting for line of business stakeholders. The SBL is the central point of contact for line of business stakeholders to discuss and or request Contracting assistance. As such they will provide leadership, consultation, facilitation, and insight to develop the annual contracting plan, adjust the plan as necessary throughout the year, and ensure Contracting delivers on the agreed upon strategic initiatives that are critical to the line of business goals and long-term strategy. This individual is accountable for assessing internal and external resources/opportunities, as well as gathering and synthesizing data to make sound business recommendations in support of our line of business strategy. In collaboration with Provider Partnerships, this individual works with cross-functional teams to advance complex large-scale projects from strategy to implementation. This individual collaborates closely with Sales, Finance, Product, Medical Management, Government Relations, Marketing, and IT resources to assure data driven business needs are effectively communicated, building consensus among vested parties that results in alignment and timely execution of the business and technology deliverables.Key Responsibilities/Duties – what you will be doing
- In conjunction with Contracting Directors, develop and update all line of business annual network strategy for Ancillary and System Contracting for Contract leadership review.
- Manage complex initiatives and/or alliances that require integration across multiple business units. Gather cross functional internal/external inputs and provide content expertise to make high level recommendations to Contracting leadership.
- Develop, maintain, and reinforce program strategy and scope; serve oversight role in ensuring programs are on track, on budget, and progressing towards business goals identified.
- Develop, manage, and lead effective and collaborative program and team structures to ensure that discussions are appropriately focused, timely, and incorporate input from internal and external subject matter experts.
- Proactively identify implications and challenges to success, and develop cross-functional strategies to address/resolve and get buy-in; escalate as needed to achieve timely resolution of issues
- Develops and coordinates reports, queries and/or extracts to support data requests and analytics related to strategic initiatives
- Represents Contracting as an SME for line of business/product forums
- Other duties and projects as assigned.
Qualifications – what you need to perform the job
Education, Certification and Licensure
- Required: Bachelor’s degree in business and/or related field or equivalent experience
- Preferred: Master’s degree preferred
Experience (minimum years required):
- Required: 5-7 years of provider contract related experience
- Required: 7-10 years of general work experience
Skill Requirements
- Must have extensive knowledge of the health plan industry and its customers, as well as expertise in strategy development/planning and project leadership.
- Strong analytic skills, with a clear understanding of dynamics of financial models, provider incentives, and contracting business processes.
- Well developed, working knowledge of managed care, insurance, and provider dynamics.
- Advanced Excel and PowerPoint skills
- Must have a proven track record of working effectively with people and processes at multiple levels
- Requires strong leadership, communication, negotiation, and conflict resolution skills.
- Strong presentation/facilita
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