<p>Site: Mass General Brigham Health Plan Holding Company, Inc.</p> <p>Mass General Brigham relies on a wide range of professionals, including doctors, nurses, business people, tech experts, researchers, and systems analysts to advance our mission. As a not-for-profit, we support patient care, research, teaching, and community service, striving to provide exceptional care. We believe that high-performing teams drive groundbreaking medical discoveries and invite all applicants to join us and experience what it means to be part of Mass General Brigham.</p> <p>Job Summary</p> <p>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).</p> <p>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.</p> <p>Essential Functions</p> <ul> <li>Develop and maintain relationships with healthcare providers, including hospitals, clinics, and physician groups. </li><li>Negotiate contracts and rates with healthcare providers to ensure cost-effective services for patients. </li><li>Analyze healthcare provider data and trends to identify opportunities for improving patient outcomes and reducing costs. </li><li>Collaborate with internal departments, including finance, legal, and operations, to ensure compliance with regulations and policies. </li><li>Provide guidance and support to healthcare providers regarding policies, procedures, and regulatory requirements. </li><li>Monitor provider performance and identify areas for improvement or corrective action. </li><li>Stay current with industry trends and advancements in healthcare provider networks. </li><li>Develop and manage departmental budgets and forecasts. </li></ul> <p>Qualifications</p> <p>Education</p> <ul> <li>Bachelor's Degree required and Master's Degree preferred </li></ul> <p>Experience</p> <ul> <li>At least 5-7 years of experience in healthcare provider network management or related field </li><li>At least 3-5 years of experience in Senior role required </li></ul> <p>Knowledge, Skills and Abilities</p> <ul> <li>Strong understanding of healthcare provider networks and regulatory requirements. </li><li>Excellent communication and negotiation skills. </li><li>Strategic planning and problem-solving abilities. </li><li>Ability to work independently and as part of a team. </li><li>Knowledge of healthcare finance and reimbursement systems. </li><li>Ability to prioritize tasks and manage multiple projects simultaneously. </li></ul> <p>Additional Job Details (if applicable)</p> <p>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%)</p> <p>Remote Type</p> <p>Hybrid</p> <p>Work Location</p> <p>399 Revolution Drive</p> <p>Scheduled Weekly Hours</p> <p>40</p> <p>Employee Type</p> <p>Regular</p> <p>Work Shift</p> <p>Day (United States of America)</p> <p>EEO Statement:</p> <p>Mass General Brigham Health Plan Holding Company, Inc. is an Equal Opportunity Employer. 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. To ensure reasonable accommodation for individuals protected by Section 503 of the Rehabilitation Act of 1973, the Vietnam Veteran's Readjustment Act of 1974, and Title I of the Americans with Disabilities Act of 1990, applicants who require accommodation in the job application process may contact Human Resources at (857)-282-7642.</p> <p>Mass General Brigham Competency Framework</p> <p>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.</p>