Program Manager

The Government Payer Policy (GPP) team, within Payer Strategy and Contracting seeks a candidate with an in-depth understanding of a broad range of health policy issues facing Mass General Brigham the health care market to manage and conduct cross-functional fiscal analyses and government policy integration efforts. The GPP Manager must have the ability to think independently, critically, strategically, broadly, and creatively; possess exceptional organizational and project management skills; have excellent written and verbal communication skills; can assess, understand, and integrate financial and other data; and can lead a multi-disciplinary group of internal constituents in a matrixed environment.

The GPP Manager will assist in the development and implementation of an overall strategy for the department to support emerging government payer challenges and opportunities. The incumbent will lead the research, organization, development and assessment of relevant policy and fiscal implications. The GPP Manager will also develop and present complex decision support materials to multiple audiences.

Department Overview:

The Payer Strategy and Contracting group evaluates key health policy, healthcare payment, and healthcare market issues in the context of MGB relations with commercial payers, Medicare, and Medicaid. The group is responsible for implementing key policy positions through the negotiation and management of contracts with health insurance plans and third-party payers on behalf of MGB providers. Examples of policy issues include:

• Payment and reimbursement issues
• Healthcare reform and regulatory issues
• Value-based care, including risk sharing and pay-for-performance quality incentive arrangements
• Reimbursement for innovative therapies and services
• New care models such as telehealth and home-based care
• Price transparency
• Pricing strategy
• Provider network development

Key responsibilities include:

• Assess the financial impact of Medicare and Medicaid payment updates, including innovative and evolving reimbursement pilots and care systems. Articulating the impact of policy proposals on the entire MGB system.
• Develop, support, and implement public payer strategy and work planning through analysis and discussion with internal stakeholders, trade organizations, and government agencies.
• Monitor the development of federal and state health care reform and innovation efforts in order to assess potential operational and financial implications for Mass General Brigham.
• Produce revenue projections for the annual budget and five-year capital framework.
• Analyze and report government payer revenue, cost, and other relevant information to internal stakeholders, federal and state agencies, and other external parties.
• Participate in, and as needed convene, internal and external task forces and advisory groups, including those sponsored by provider associations and government agencies;
• Utilize data and analytics to frame key issues and impacts to patients, providers and hospitals around government policy, payment models, and system design.
• Use/s the Mass General Brigham values to govern decisions, actions, and behaviors. These values guide how we get our work done: Patients, Affordability, Accountability & Service Commitment, Decisiveness, Innovation & Thoughtful Risk; and how we treat each other: Diversity & Inclusion, Integrity & Respect, Learning, Continuous Improvement & Personal Growth, Teamwork & Collaboration.
• Acts as a Subject Matter Expert in regard to the healthcare market for the organization and the Payer Strategy and Contracting group.
• Manage multiple projects comprising cross-functional internal teams, including colleagues both at MGB corporate and at the network entities, as well as external constituents.
• Build and continuously foster relationships with internal and external counterparts and other key stakeholders.
• Develop and present complex presentation materials (incorporating financial terms) for a variety of audiences including senior leadership.
• Staff supervision include recruitment, professional development, and performance management.
• Assist in the oversight and prioritization of work assignments, monitor the quality and accuracy of deliverables, and ensure timely delivery of projects.
• Other duties as assigned

Qualifications:

• Bachelor’s degree required in related fields such as business, health care administration, health care management, finance, or law. Master’s degree preferred. Seven to 10 plus years of closely related experience required.
• Five plus years managing people preferred.
• Healthcare background and previous exposure to healthcare policy required.
• Experience working with external clients preferred
• A combination of education and experience may be substituted for requirements

• Possess strong interpersonal skills to effectively communicate with cross functional teams including staff at all levels of the organization, both verbally and in writing.
• Ability to successfully project manage and collaborate with others of different skill sets, backgrounds, and levels within and external to the organization
• Strong problem solving skills
• Ability to effectively conduct meetings, both formal and informal
• Requires minimal direction from leadership and possesses the ability to learn quickly
• Proven ability to think creatively about a problem by skillfully analyzing, assessing, and reconstructing (financial and non-financial) information to determine solutions.
• Ability to design, develop, interpret, and synthesize financial data/analysis