Sr. Program Manager

Ready to help us transform healthcare? Bring your true colors to blue. 

What we need

Network Quality & Development plays a leadership role with the full spectrum of BCBSMA quality incentive programs for our provider network, including our ambulatory, hospital, behavioral health and ancillary provider contract programs.   The Senior Manager is responsible for a portfolio of provider relationships, and for each of these provider organizations, has responsibility for the end-to-end process from negotiations related to the quality incentive program through annual settlement based on provider performance.  The Senior Manager is a resource to the quality teams at hospitals, behavioral health facilities, and providers in their quality improvement work through responding to questions on program components and/or measures and supporting their contractual requirements. 

Your Day to Day

For a portfolio of providers, assume lead responsibility for all aspects of the contract negotiation process related to the quality program, measure set, and quality incentive structure while collaborating with Network Contracting and/or Ancillary Contracting Act as a resource to providers to understand quality contractual requirements, measures, and program requirements Manage contractual deliverables (i.e. data submissions, reporting deliverables) and provide guidance and support to assigned provider incentive partners including tracking, collection, and review of data and deliverables Collaborate with the Network Quality & Development and Performance Measurement & Improvement in the annual review and updates of our quality incentive programs and associated measure sets and program requirements Collaborate with the team on the completion of the quality settlements for each of the programs

This document is not an exhaustive list of all responsibilities, skills, duties, requirements, or working conditions associated with the job. Employees may be required to perform other job-related duties.

We’re Looking for:

• Strong negotiation and interpersonal skills in dealing with all levels of management.
• Ability to work cross-functionally with senior executives and internal/external customers
• Excellent verbal and written communication skills.
• Excellent time management skills and ability to plan and set priorities.
• Knowledge of quality measurement, provider incentives, and quality improvement
• Clinical knowledge or experience working within provider organizations
• Very strong technical aptitude with the ability to use Microsoft products, particularly Excel.

What You Bring:

• Bachelor’s degree in related field required, advanced degree in business, public health or health care related industry highly desirable
• Minimum 3-7 years relevant experience working in quality at a physician practice or hospital, and/or health plan.

What You’ll Gain:

• This is a high profile position in which you work with our provider network on our innovative provider quality incentive programs from program development, negotiation through annual settlement. You will work with leaders across the organization as well as providers throughout the network in support of our contractual requirements and quality measures for each of the programs – hospital, ambulatory, mental health, and other ancillary providers.

It is our mission at Blue Cross Blue Shield of Massachusetts to foster a culture that enables associates to do their best work while living happy and healthy lives. That's why we offer you a variety of ways to support your best physical, emotional, financial, and social well-being. For more information on our benefit offerings, visit https://careers.bluecrossma.org/us/en/benefits

Minimum Education Requirements:

High school degree or equivalent required unless otherwise noted above

Location

Boston, Hingham

Time Type

Full time

Salary Range: $121,670.00 - $152,350.00

The job posting range is the lowest to highest salary we in good faith believe we would pay for this role at the time of this posting.  We may ultimately pay more or less than the posted range, and the range may be modified in the future.  An employee’s pay position within the salary range will be based on several factors including, but limited to, relevant education, qualifications, certifications, experience, skills, performance, shift, travel requirements, sales or revenue-based metrics, and business or organizational needs and affordability.

This job is also eligible for variable pay.