Sr. Manager, Contract Support - Health Plan Finance (Hybrid)

Overview

Pay Range: $130,000 - $180,000 / year

Salary offers are based on a wide range of factors including relevant skills, training, experience, education, and, where applicable, certifications obtained. Market and organizational factors are also considered. Successful candidates may be eligible to receive annual performance bonus compensation.

 

Benefits Information:

We are proud to offer best-in-class benefits and programs to support employees and their families in living healthy, happy lives. Our pay and benefit plans have been designed to promote employee health in all respects – physical, financial, and developmental. Depending on whether it is a part-time or full-time position, some of the benefits offered may include:

· Day 1 Medical, supplemental health, dental & vision for FT employees who work 30+ hours

· Best-in-class well-being programs

· Annual, no-cost health assessment program Blueprint for Wellness®

· healthyMINDS mental health program

· Vacation and Health/Flex Time

· 6 Holidays plus 1 "MyDay" off

· FinFit financial coaching and services

· 401(k) pre-tax and/or Roth IRA with company match up to 5% after 12 months of service

· Employee stock purchase plan

· Life and disability insurance, plus buy-up option

· Flexible Spending Accounts

· Annual incentive plans

· Matching gifts program

· Education assistance through MyQuest for Education

· Career advancement opportunities

· and so much more!

 

The Sr. Manager supports the financial and operational evaluation of prospective Health Plan contracts, providing consulting and recommendations to insure growth and profitability of third-party payors. Towards this goal, works closely with Health Plan Sales, Regional Finance, Revenue Recognition and other Health Plan Finance Sr. Managers.  Partners with representatives of the Health Plan sales organization in response to contract proposals for regional and national contracts.

Responsibilities

• Responsible for all financial analyses required for prospective third-party contracts including the compilation of fee schedules, revenue projections, synergy analyses and “what-if” scenarios
• Partners with the VP of Health Plans, Regional Executive Directors, and Account Executives in determining strategies for Health Plan negotiations as well as the management of the contract pipeline
• Where appropriate, directly participates in the negotiation process for key plans including the development of contracting and pricing strategies, customer presentation content, and finance support
• Manages a staff of direct reports responsible for the analyses and modeling approaches of contract financial terms and levers
• Ownership of full Profit & Loss statements along with related financial measures.  Understanding of the drivers and inputs to each financial line item and/or financial measure
• Assists Legal in reviewing prospective contracts to ensure requirements can be operationalized and are in line with company objectives
• Supports the development of standard premium priced tests, capitation carve-outs and overall pricing guidelines
• Works closely with the Clinical Franchise department to ensure that pricing guidelines for high value and new test campaigns are considered in prospective contracts
• Interfaces directly with regional leadership regarding the price, volume, and cost implications associated with new and existing third-party contracts
• Develops methods to streamline the pricing review and authorization process for third-party contracts
• Supports the annual budget process providing details and insights on known and potential contract changes in the coming year
• Collaborates with team members to ensure consistency in processes and identify areas of improvement through automation and lean practices.
• Provides guidance to staff on interpretation of billing data and works with Billing function on code setup for new and revised contracts.
• Ad-hoc projects as needed

Qualifications

• Bachelor’s degree
• A minimum of five years relevant financial analysis / financial modeling experience
• Strong understanding of the healthcare industry and health plans specifically (product types, trends, etc.)
• Strong financial and analytical skills
• Innovative thinker comfortable with ambiguity to complete tasks
• Ability to work effectively cross-functionally in a matrix environment and build/maintain relationships
• Excellent verbal and written communication skills
• Ability to work effectively both independently and within a team
• Experience working with and supporting a Commercial/Sales organization a plus
• Strong PC skills (Excel, Access, Power