Sr. Program Manager

Network Quality & Development Manager

Ready to help us transform healthcare? Bring your true colors to blue. 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

• 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

We're Looking For :

What You Bring :

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.

Location : Boston, Hingham

Time Type : Full time

Salary Range : $121,670.00 - $152,350.00

Blue Cross Blue Shield of Massachusetts is an Equal Employment Employer - veterans / disability. Applicants are considered for all positions without regard to race, color, religion, sex, national origin, age, veteran status, disability, sexual orientation, gender identity or expression, or any other characteristics protected by law.