Sr. Program Manager

What we need

Network Quality & Development plays a leadership role with the full spectrum of BCBSMA quality incentive programs for our provider network, including our ambulatory, hospital, behavioral health and ancillary provider contract programs. The Senior Manager is responsible for a portfolio of provider relationships, and for each of these provider organizations, has responsibility for the end-to-end process from negotiations related to the quality incentive program through annual settlement based on provider performance. The Senior Manager is a resource to the quality teams at hospitals, behavioral health facilities, and providers in their quality improvement work through responding to questions on program components and/or measures and supporting their contractual requirements.

Your Day to Day

For a portfolio of providers, assume lead responsibility for all aspects of the contract negotiation process related to the quality program, measure set, and quality incentive structure while collaborating with Network Contracting and/or Ancillary Contracting Act as a resource to providers to understand quality contractual requirements, measures, and program requirements Manage contractual deliverables (i.e. data submissions, reporting deliverables) and provide guidance and support to assigned provider incentive partners including tracking, collection, and review of data and deliverables Collaborate with the Network Quality & Development and Performance Measurement & Improvement in the annual review and updates of our quality incentive programs and associated measure sets and program requirements Collaborate with the team on the completion of the quality settlements for each of the programs

This document is not an exhaustive list of all responsibilities, skills, duties, requirements, or working conditions associated with the job. Employees may be required to perform other job-related duties.

We're Looking for:

• Strong negotiation and interpersonal skills in dealing with all levels of management.
• Ability to work cross-functionally with senior executives and internal/external customers
• Excellent verbal and written communication skills.
• Excellent time management skills and ability to plan and set priorities.
• Knowledge of quality measurement, provider incentives, and quality improvement
• Clinical knowledge or experience working within provider organizations
• Very strong technical aptitude with the ability to use Microsoft products, particularly Excel.

What You Bring:

• Bachelor's degree in related field required, advanced degree in business, public health or health care related industry highly desirable
• Minimum 3-7 years relevant experience working in quality at a physician practice or hospital, and/or health plan.

What You'll Gain:

• This is a high profile position in which you work with our provider network on our innovative provider quality incentive programs from program development, negotiation through annual settlement. You will work with leaders across the organization as well as providers throughout the network in support of our contractual requirements and quality measures for each of the programs - hospital, ambulatory, mental health, and other ancillary providers.

It is our mission at Blue Cross Blue Shield of Massachusetts to foster a culture that enables associates to do their best work while living happy and healthy lives. That's why we offer you a variety of ways to support your best physical, emotional, financial, and social well-being. For more information on our benefit offerings, visit https://careers.bluecrossma.org/us/en/benefits

High school degree or equivalent required unless otherwise noted above

The job posting range is the lowest to highest salary we in good faith believe we would pay for this role at the time of this posting. We may ultimately pay more or less than the posted range, and the range may be modified in the future. An employee's pay position within the salary range will be based on several factors including, but limited to, relevant education, qualifications, certifications, experience, skills, performance, shift, travel requirements, sales or revenue-based metrics, and business or organizational needs and affordability.

This job is also eligible for variable pay.

We offer comprehensive package of benefits including paid time off, medical/dental/vision insurance, 401(k), and a suite of well-being benefits to eligible employees.

Note: No amount of pay is considered to be wages or compensation until such amount is earned, vested, and determinable. The amount and availability of any bonus, commission, or any other form of compensation that are allocable to a particular employee remains in the Company's sole discretion unless and until paid and may be modified at the Company's sole discretion, consistent with the law.

WHY Blue Cross Blue Shield of MA?

We understand that theconfidence gapandimposter syndromecan prevent amazing candidates coming our way, so please don't hesitate to apply. We'd love to hear from you. You might be just what we need for this role or possibly another one at Blue Cross Blue Shield of MA. The more voices we have represented and amplified in our business, the more we will all thrive, contribute, and be brilliant. We encourage you to bring us your true colors, , your perspectives, and your experiences. It's in our differences that we will remain relentless in our pursuit to transform healthcare for ALL.

As an employer, we are committed to investing in your development and providing the necessary resources to enable your success. Learn how we are dedicated to creating an inclusive and rewarding workplace that promotes excellence and provides opportunities for employees to forge their unique career path by visiting ourCompany Culturepage. If this sounds like something you'd like to be a part of, we'd love to hear from you. You can also join ourTalent Communityto stay "in the know" on all things Blue.

At Blue Cross Blue Shield of Massachusetts, we believe in wellness and that work/life balance is a key part of associate wellbeing. For more information on how we work and support that work/life balance visit our "How We Work" Page.