Senior Provider Network Account Executive

Mass General Brigham Health Plan
United States, Massachusetts, Somerville
399 Revolution Drive (Show on map)
Mar 28, 2025
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. 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 field At 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. Physical Requirements Standing 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%) 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.