Location: Boston - Hybrid
Job Summary:
Under the direction of the Vice President of Corporate Strategy & ACO Contracting and in partnership with Executive Leadership, the Senior Director, Payor Contracting is responsible for contributing to the organization's success in managing the organization's business development efforts in the areas of new value-based contracts and provider contracting.
Responsibilities:
- Lead the organization's payor and provider contracting strategy across multiple markets in partnership with the Executive Team
- Identify opportunities for new value-based contracts on behalf of Federally Qualified Health Center partners and assess both the Company's and FQHCs capacity to expand into new markets
- Manage key strategic initiatives related to the organization's payor contracting strategy, including entry into new geographic areas and markets
- Develop and maintain partner relationships with health plans and provider organizations to meet the organization's contracting objectives
- Assist in the development and management of C3's business development efforts related to value-based contracting
- Work with the National Strategy team to research, identify and negotiate value-based contracting opportunities in new markets across multiple payors
- Negotiate with payors and oversee the procurement of new payor contracts, principally risk- based contracts
- Partner with analytics and actuarial teams to understand and predict P&L from new value- based contracts
- Maintain communications with all stakeholders in the contracting process, including payors, C3 Leadership, and Federally Qualified Health Center partners
- Understand and communicate contractual requirements and in coordination with leadership, ensure compliance on contract terms
- Conduct due diligence on new contract terms and assist in future gain/loss projections
- As necessary, work with Operations, Clinical Operations, Quality, Risk Adjustment, and other departments as appropriate to ensure broad-based understanding of contract requirements
- As necessary, assist in the implementation of all new payor contracts
- Participate in the monitoring of success in the organization's value-based contracting efforts
- Some business travel may be required
- All other duties as assigned
Required Skills:
- Strong analytical skills
- Healthcare experience required, including experience with value-based contracts strongly preferred
- Experience with Federally Qualified Health Centers, including their Federal financing structure, preferred
- Excellent written and oral communications to a senior leader audience, including the ability to present complex situations and financial analysis in a clear and concise manner
Desired Other Skills:
- Track record of facilitating diverse stakeholders toward shared recommendations
- Familiarity with value-based contracts
- Familiarity with Federally Qualified Health Centers
- Experience with anti-racism activities, and/or lived experience with racism is highly preferred
Qualifications:
- Bachelor's Degree required
- Post-graduate degree in health care, business administration, law, or finance field preferred
- 7-10 years of professional experience strongly preferred
- Experience in health plan and/or provider network contracting required, 5-7 years strongly preferred
