Consultant, Negotiation Planning and Analysis

Where

Boston, MA

What you'll be doing

Assist in the development and maintenance of processes and tools to monitor BCBSMA provider network contract renewals and to ensure the delivery of accessible, high quality networks to BCBSMA members and physicians. Work collaboratively with supporting departments to develop and implement key negotiation support tools such as financial models, contract databases, data analytics, and organizational approaches. Also, assist in the development of and conduct internal education programs for network contracting on such negotiation support tools. Provide ad-hoc support to ongoing negotiations of hospital agreements and specialized physician agreements, or risk agreements. Contribute to the development of creative contracting strategies, reimbursement structures, networks and approaches. Work closely with other associates to collaborate with and support all corporate groups impacted by hospital and physician organization contract renewals, including product, sales, marketing, finance, provider organization management, provider relations & communication, case creation, clinical coordination, consumer affairs, corporate affairs, IT, legal, member service, HCQC, provider services, and enrollment. Areas of collaboration include account/consultant/broker presentations, network communications, provider directory development, sales strategy development, ad hoc report creation, regulatory issues (i.e., BCBSA, NPI, HIPAA, and federal/state filings), pricing strategy and updates, and communication of trends in cost, quality and use. Monitor and track contracting initiatives in accordance with BCBSMA business requirements, quality incentive programs, unit cost trend budget requirements, and responsibilities to accounts and members. Work closely with other network contracting associates to develop departmental awareness of BCBSMA programs and initiatives that impact the network contracting strategies and formalize and document existing processes for hospital and physician contract renewals. Build cross-functional consensus for these initiatives with all corporate groups impacted. Perform audits of contracts and contract loading to ensure accuracy with negotiated agreements. Identify existing business risks associated with current agreements and establish a means to mitigate, and where possible, eliminate such risk.

What your background should be

This position is required 3 to 5 years of relevant experience. Solid understanding of provider contract development and contract language; demonstrated analytical strength and ability to understand financial arrangements and analysis; demonstrated strength in finance to support financial arrangements and analysis; demonstrated understanding of health care reimbursement methods and strategies. Demonstrated ability to influence, negotiate, and operate collaboratively as part of a team. Ability to identify, communicate, and manage risk. Solid written/verbal communication skills; effective presentation skills; project management and planning skills. Strong attention to detail, process, deadlines and quality results. Proven track record of meeting project timeliness/deliverables.

Required Schooling / Training

Bachelor degree.

Who is the client company

Concern about health insurance services.

If you are interested in this position, send your resume to apply@kochdavis.com