Lead and shape provider networks across New Hampshire, Vermont, and Maine by managing end-to-end contracting processes for physician groups, hospitals, and specialty providers. This role focuses on building sustainable partnerships that support both fee-for-service and value-based care models, ensuring alignment with broader clinical and financial goals.
Key Responsibilities
- Direct negotiations for complex provider agreements, balancing cost efficiency with network adequacy and quality outcomes
- Develop strategic network positioning to identify opportunities in risk-based and incentive-driven arrangements
- Collaborate with cross-functional teams including claims, medical management, and credentialing to ensure seamless implementation of provider contracts
- Analyze financial impacts of contract terms and model alternative structures to meet cost targets
- Resolve escalated provider concerns using deep knowledge of local market dynamics and operational workflows
- Support initiatives that improve medical cost trends and care quality through data-informed decision making
- Maintain accuracy in contract execution and lifecycle management across healthcare provider agreements
Qualifications
Candidates should bring at least three years of experience in healthcare provider contracting, with demonstrated success in negotiating with complex medical groups and health systems. A background in managed care or health insurance is essential, along with proven abilities in financial analysis, relationship management, and contract interpretation.
Strong communication and presentation skills are required to influence internal stakeholders and external partners. Familiarity with reimbursement models, particularly performance-based incentives, is highly valued. Leadership experience, including mentoring others, is expected.
A bachelor’s degree in a related field is preferred; an MBA or MHA enhances competitiveness. Proficiency in Microsoft Office is required.
Work Environment
This position operates in a hybrid model, based in Newton, MA, with required in-office presence and limited remote work. Remote connectivity must meet minimum broadband standards: cable or fiber optic internet with download speeds of at least 10Mbps and upload speeds of 5Mbps.
Compensation and Benefits
The annual salary range for this role is $92,000 to $153,300. Eligible employees may participate in an annual bonus plan and receive equity considerations.
Comprehensive benefits begin on day one, including medical, vision, and dental coverage. Additional offerings include 401(k) with company match, company-paid life insurance, tuition reimbursement, and access to well-being and behavioral health resources. Employees accrue a minimum of 18 days of paid time off annually, in addition to paid holidays.
