Director, Provider Partnerships Strategy and Analytics

Who We Are

Point32Health is a leading not-for-profit health and well-being organization dedicated to delivering high-quality, affordable healthcare. Serving nearly 2 million members, Point32Health builds on the legacy of Harvard Pilgrim Health Care and Tufts Health Plan to provide access to care and empower healthier lives for everyone. Our culture revolves around being a community of care and having shared values that guide our behaviors and decisions. We’ve had a long-standing commitment to inclusion and equal healthcare access and outcomes, regardless of background; it’s at the core of who we are. We value the rich mix of backgrounds, perspectives, and experiences of all of our colleagues, which helps us to provide service with empathy and better understand and meet the needs of the communities where we serve, live, and work. 

We enjoy the important work we do every day in service to our members, partners, colleagues and communities. Learn more about who we are at Point32Health.

Job Summary

The Director of Provider Partnerships Strategy plays a critical leadership role within the Provider Partnerships organization. Working closely with the Senior Vice President of Provider Partnerships, the Vice President of Provider Partnerships Strategy, the Provider Partnerships leadership team and Line of Business stakeholders, the Director of Provider Partnerships Strategy leads provider network strategic initiatives and their tactical execution, ensuring alignment with the Lines of Business and the organization’s overall financial, operational, and clinical goals. The Director manages a team of colleagues supporting analytics and network consultancy aligned to the strategic focus of the team she/he is managing, such as Government or Commercial Products. Working in a matrix environment to support and collaborate with colleagues from System Contracting, Ancillary Contracting, Actuarial, Sales and Provider Performance, he/she oversees the development and timely delivery of relevant and meaningful analyses and presentations in support of Point32Health’s provider contracts and network performance.


In addition to the Lines of Business, this individual collaborates closely with Sales, Finance, Product, Medical Management, Government Relations, Marketing, IT, and other enterprise-level teams to assure business needs are effectively communicated, building consensus among vested parties that results in alignment and timely execution of the business deliverables.

Job Description

DUTIES/RESPONSIBILITIES – what you will be doing (top five):

• Design and implement processes to support effective Provider Partnerships overall governance, including developing and executing multi-year department strategy, continuous alignment with the various lines of business, operational capacity planning/mapping, and management of Key Performance Indicators (KPIs) for the department
• Support the coordination and execution of enterprise processes, including and not limited to the Monthly Operations Review (MOR), Run the Business (RTB), Affordability of Care and Total Cost of Care process improvement efforts, Finance reviews & reforecasting, Contract Executive Committee as well as the CMPO/CPC Annual Planning process and Board of Directors meetings
• Proactively identify and oversee the development of analyses, models, and tools to offer an informed view of provider, network, and contract performance
• In collaboration with System and Ancillary Contracting leadership, formulate and execute on strategies to improve unit cost, standardize reimbursement methodologies, and maintain competitive provider network
• Provide direction and define approach and parameters for overall reimbursement strategy and payment methodologies, with the goal of standardization, optimization, and transparency. Oversee development of provider rates in line with negotiated terms
• Oversee the submission of regulatory submissions and requests
• Monitor, analyze and report on competitive position for all applicable Point32Health markets
• Produce accurate and timely reporting on network access and adequacy, ensuring standards are maintained and gaps are appropriately addressed
• Provide on-going leadership and program/project management support for foundational and strategic initiatives
• Design communications for and support executive-level presentation by the SVP of Provider Partnerships
• Develop and execute business plans, project charters and work breakdown structures, specifying goals, strategy, governance, staffing, scheduling, identification of risks, contingency plans, and communication plans as necessary
• Recruit, train and develop talent; provide co