Career Center

The Manager of Specialty Contracting and Value is responsible for providing systematic, analytic, and operational support on managed care contracting and value-driven activities. The role will assist in the development of new payor strategies and models of payment that will support the Institute???s growth targets and business partnership strategies into the future, particularly specialty pharmacy and alternative sites of care.??

As new approaches are developed, this position will be responsible for developing the infrastructure, analytical support, and operational metrics required to administer the models and track performance and other key indicators as necessary. The Manager of Specialty Contracting is a critical member of the managed care contracting team and will be assigned the management of specific projects and payor accounts for certain specialized services. Responsibilities for contracting will include securing appropriate internal data and working with third party health plans, brokers, PBMs, and others to negotiate appropriate rates and terms. ??

This position is fully remote with flexibility to come onsite if needed peridocially. Please note that any qualified candidates must reside in MA, RI, or NH.

Located in Boston and the surrounding communities, Dana-Farber Cancer Institute brings together world renowned clinicians, innovative researchers and dedicated professionals, allies in the common mission of conquering cancer, HIV/AIDS and related diseases. Combining extremely talented people with the best technologies in a genuinely positive environment, we provide compassionate and comprehensive care to patients of all ages; we conduct research that advances treatment; we educate tomorrow's physician/researchers; we reach out to underserved members of our community; and we work with amazing partners, including other Harvard Medical School-affiliated hospitals.

Value payment models

• Build a strategic response to programs and analysis that will improve the value of cancer care at DFCI at the local and population health level that will align with DFCI strategic plans.
• Evaluate emerging payment models including CMS Center for Medicare and Medicaid innovation (CMMI) and alternative payment models (APM).
• Assure and develop an infrastructure to define and report meaningful metrics from varying perspectives. Clinical outcomes, data collection and abstraction, and capacity for improvement will be highly aligned with the goals and work of the Alliance of Dedicated Cancer Centers (ADCC).
• Complete research and provide any necessary analysis on selected topics related to health reform, pay for performance/quality, value and other critical topics. Present findings to a large cross section of departments throughout the organization.
• Prepare analyses and executive summaries for senior leadership as requested.

Specialty Contract Negotiation and Monitoring

• Manage all aspects of contract negotiations with health plans/agencies/networks/other ancillary entities on behalf of hospital. These discussions include legal, business, financial and clinical considerations.
• Collaborate with supervisor and finance representatives on the creation of the most appropriate tools, models, and reports to evaluate financial performance of existing and/or prospective payer agreements to meet budgetary targets.
• Identify and advise internal clients of potential business/legal issues found during contract review and negotiations to enable making informed decisions concerning such issues. Propose potential boilerplate language modifications to remedy identified issues.
• Review and negotiate miscellaneous contracts with ancillary payers, including, pharmacy benefit managers, durable medical equipment (DME), and hospice.
• Develop periodic tracking and metrics necessary to monitor performance via claims review and other data sources.
• Work closely with impacted operating units and support areas to improve functions across Business Alliance and Revenue Cycle departments.

Research/Special Projects

• Provide ad hoc reporting to supervisor and leadership on topics of health reform, APM, value contracting and relevant trends that could influence DFCI strategy.

??

At Dana-Farber Cancer Institute, we work every day to create an innovative, caring, and inclusive environment where every patient, family, and staff member feels they belong.?? As relentless as we are in our mission to reduce the burden of cancer for all, we are equally committed to diversifying our faculty and staff.?? Cancer knows no boundaries and when it comes to hiring the most dedicated and diverse professionals, neither do we. If working in this kind of organization inspires you, we encourage you to apply.

MINIMUM JOB QUALIFICATIONS:

• Bachelor???s degree required; MPH, MBA (healthcare, business, administration) or JD preferred.??
• 5 years of relevant experience in health care provider, health plan, specialty pharmacies, pharma or related setting required; 2 years with a master???s degree.
• Experience negotiating contractual agreements required, working across complex systems/operations managing complex topics, or in sales required.

KNOWLEDGE, SKILLS, AND ABILITIES REQUIRED:

• Knowledge of clinical delivery systems, third party reimbursement, commercial and government payment methodologies and health sector payment reform initiatives, particularly pharmacy PBM contract models.
• Intermediate/Advanced proficiency in Microsoft business applications, i.e., PowerPoint, Excel, Word, Access. ??Tableau and MicroStrategy, EPIC, Epsi and Strata preferred.
• Exceptional analytical and communication skills.
• Proven informational and persuasive writing skills.
• Ability to perform spreadsheet analysis and have financial analytical acumen.
• Ability to present findings to a large cross section of departments throughout the organization.
• Ability to manage others vertically across many departments ??? (Revenue cycle, provider staff office, pharmacy, clinical Ops).

Dana-Farber Cancer Institute is an equal opportunity employer and affirms the right of every qualified applicant to receive consideration for employment without regard to race, color, religion, sex, gender identity or expression, national origin, sexual orientation, genetic information, disability, age, ancestry, military service, protected veteran status, or other groups as protected by law.