Site: Mass General Brigham Health Plan Holding Company, Inc.

 

At Mass General Brigham, we know it takes a surprising range of talented professionals to advance our mission—from doctors, nurses, business people and tech experts, to dedicated researchers and systems analysts. As a not-for-profit organization, Mass General Brigham is committed to supporting patient care, research, teaching, and service to the community.  We place great value on being a diverse, equitable and inclusive organization as we aim to reflect the diversity of the patients we serve.

At Mass General Brigham, we believe a diverse set of backgrounds and lived experiences makes us stronger by challenging our assumptions with new perspectives that can drive revolutionary discoveries in medical innovations in research and patient care. Therefore, we invite and welcome applicants from traditionally underrepresented groups in healthcare — people of color, people with disabilities, LGBTQ community, and/or gender expansive, first and second-generation immigrants, veterans, and people from different socioeconomic backgrounds – to apply.

 

 

Job Summary

This is a hybrid role. It will require an onsite presence at the office in Assembly Row, Somerville, MA at least 1x/month (for team meetings, meetings with providers, and external forums).

Responsible for managing relationships with MGB providers to ensure quality care and cost-effective services for patients, which includes training/educating providers. A strong understanding of claims is highly preferred.

Essential Functions
-Develop and maintain relationships with healthcare providers, including hospitals, clinics, and physician groups.
-Negotiate contracts and rates with healthcare providers to ensure cost-effective services for patients.
-Analyze healthcare provider data and trends to identify opportunities for improving patient outcomes and reducing costs.
-Collaborate with internal departments, including finance, legal, and operations, to ensure compliance with regulations and policies.
-Provide guidance and support to healthcare providers regarding policies, procedures, and regulatory requirements.
-Monitor provider performance and identify areas for improvement or corrective action.
-Stay current with industry trends and advancements in healthcare provider networks.
-Develop and manage departmental budgets and forecasts.

 

Qualifications

Education

Bachelor's Degree required and Master's Degree preferred

Experience

At least 5-7 years of experience in healthcare provider network management or related fieldAt least 3-5 years of experience in Senior role required

Knowledge, Skills and Abilities

Strong understanding of healthcare provider networks and regulatory requirements.Excellent communication and negotiation skills.Strategic planning and problem-solving abilities.Ability to work independently and as part of a team.Knowledge of healthcare finance and reimbursement systems.Ability to prioritize tasks and manage multiple projects simultaneously.

 

Additional Job Details (if applicable)

Physical RequirementsStanding Frequently (34-66%) Walking Frequently (34-66%) Sitting Occasionally (3-33%) Lifting Frequently (34-66%) 35lbs+ (w/assisted device) Carrying Frequently (34-66%) 20lbs - 35lbs Pushing Occasionally (3-33%) Pulling Occasionally (3-33%) Climbing Rarely (Less than 2%) Balancing Frequently (34-66%) Stooping Occasionally (3-33%) Kneeling Occasionally (3-33%) Crouching Occasionally (3-33%) Crawling Rarely (Less than 2%) Reaching Frequently (34-66%) Gross Manipulation (Handling) Frequently (34-66%) Fine Manipulation (Fingering) Frequently (34-66%) Feeling Constantly (67-100%) Foot Use Rarely (Less than 2%) Vision - Far Constantly (67-100%) Vision - Near Constantly (67-100%) Talking Constantly (67-100%) Hearing Constantly (67-100%)

 

Remote Type

Hybrid

 

Work Location

399 Revolution Drive

 

Scheduled Weekly Hours

40

 

Employee Type

Regular

 

Work Shift

Day (United States of America)

 

EEO Statement:

Mass General Brigham Health Plan Holding Company, Inc. is an Equal Opportunity Employer. By embracing diverse skills, perspectives and ideas, we choose to lead. All qualified applicants will receive consideration for employment without regard to race, color, religious creed, national origin, sex, age, gender identity, disability, sexual orientation, military service, genetic information, and/or other status protected under law. We will ensure that all individuals with a disability are provided a reasonable accommodation to participate in the job application or interview process, to perform essential job functions, and to receive other benefits and privileges of employment.

 

Mass General Brigham Competency Framework

At Mass General Brigham, our competency framework defines what effective leadership “looks like” by specifying which behaviors are most critical for successful performance at each job level. The framework is comprised of ten competencies (half People-Focused, half Performance-Focused) and are defined by observable and measurable skills and behaviors that contribute to workplace effectiveness and career success. These competencies are used to evaluate performance, make hiring decisions, identify development needs, mobilize employees across our system, and establish a strong talent pipeline.