Senior Director, Finance and Contracting at Boston… · Boston

Company Description

Boston Medical Center is an extraordinary community of health care providers devoted to the proposition that every person, regardless of his or her social or economic circumstances, deserves the best health care.

Our mission is simple: to provide exceptional care, without exception.

BMC provides superior, comprehensive care in virtually every medical specialty. Our physicians are leaders in their fields with the most advanced medical technology at their fingertips and a highly–skilled nursing and professional staff working with them side-by-side. No matter who you meet at BMC – from the x-ray technician to the critical care nurse, the admissions staff to the chief of surgery – all are committed to providing top-notch care to every patient and family member with respect, warmth and compassion.

Located in Boston´s historic South End neighborhood, BMC is a private, not-for-profit, 496-bed, academic medical center and the primary teaching affiliate for Boston University School of Medicine. Consistent with its mission to provide the best in health care to all, BMC is the largest safety net hospital in New England and reaches into the community as a founding partner of Boston HealthNet, a network of 15 community health centers through Boston serving more than a quarter million people annually.

By combining a commitment to uncompromising excellence with a commitment to caring for those most in need, BMC has become a national model of care, and caring, for all.

Job Description

The Senior Director of Finance and Contracting is a shared position between BMC Finance and the ACO. A key member of the ACO leadership team and reporting to BMC’s CFO and the ACO Executive Director, he/she is accountable for system contracting, including both with payers and with ACO network providers. He/she is also accountable for ACO finances, budget and financial management systems and working with BMC finance regarding integration and impact of ACO finances and system contracts within the larger system finances. The Senior Director works with the ACO and hospital management teams, physician leadership, and ACO provider network leadership to develop and implement system contracting and finance strategies, goals and objectives. Serves as a lead negotiator on highly complex system contracts. Ensures compliance with all contractual obligations and responsible for the identification of areas for contractual improvements and optimization. Serves as key contact with health plan payers and as an internal resource to the FPP, group practice administrators, and ACO providers on contractual and financial issues. Ensures effective education and handoffs from contracts to impacted operational areas. Accountable for working with provider network to develop effective funds flow which appropriately incentivize desired behaviors and outcomes. Ensures accurate payer settlements and funds communication and distribution.

• Responsible for ACO budget development, tracking and oversight, working to ensure fiscal responsibility and success. Leads budget approval process.

• Staffs the ACO Finance Committee(s), Funds Flow committees and system contracting strategy work group efforts.

• Effectively facilitates ACO funds flow development, approval and implementation, which appropriately incentivizes desired behaviors and outcomes.

• Develops systems and processes to ensure accurate and timely fiscal management. Ensures timely financial reporting and issues resolution. Measures and routinely reports on contract performance, ensures proper booking of liabilities or receivables with BACO and hospital or BMC System.

• Works with BMC finance regarding integration and impact of ACO finances and system contracts within larger system finances. Works with others to ensure actuarial success regarding risk contracts.

• Lead communicator with ACO and BMC regarding ACO finance, funds flow and contract issues. Serves as a resource to Boston Medical Center Health Plan, FPF and ACO network to communicate salient contractual, regulatory and financial issues.

• Identifies and evaluates opportunities for optimizing performance under contractual arrangements inclusive of governmental payers and Value Based Purchasing.

• Takes the lead and works with BMC and ACO to develop policies and procedures regarding applicable contracting and financial issues, such as regarding reinsurance and reserves.

• Takes lead in developing health plan payer strategy.

• Evaluates potential and existing contracts for financial viability, strategic importance and opportunities.

• Negotiates and renegotiates rates, fee schedules and contractual obligations for BMC, physicians and ACO network.

• Oversees the negotiation of contracts with potential and renewing ACO network providers.

• Collaborates with staff to develops and maintain relationships with payers and potential and existing provider partners

• Works with and/or oversees staff participation in cross functional teams to evaluate compliance with contractual administrative and operational requirements. Oversees and ensures that administrative guidelines and operational requirements of contracts are met.

• Along with contracting and finance staff, serves as internal contact for hospital administration, legal counsel, health centers and network provider administrators on managed care contract and finance issues.

• Oversees settlement process and resolution of any issues. Coordinates the analytic and operational work related to analyzing contract rate proposals as well as any associated contract settlement issues.

• Supports evaluation of opportunities that would impact future business and service lines.

• Develops and manages ACO contract and finance managers, ensuring effective and efficient department systems and processes and developing staff to meet ACO’s current and future needs. Other work duties as assigned.

• Effective team player.

Qualifications

EXPERIENCE:

At least ten (10) years progressive management experience in hospital, group practice or managed care plan required. Experience must include leadership role in managed care and contract finance.

KNOWLEDGE AND SKILLS:

· Comprehensive knowledge of the financial, contractual and operational requirements of managed care organizations, hospital and groups practices.

· Strong knowledge of funds flow methodologies

· Strong interpersonal skills, a high degree of analytical ability, and the ability to work effectively with both internal and external customers.

· Strong contract negotiation skills and abilities.

· Excellent organization and management skills, the ability to set strategy and lead a team in a fast paced environment

· Excellent management and communication skills

Additional Information

At Boston Medical Center, we understand that individuals like you who take on a role within the health care community possess an integral desire to help others achieve their best. We feel the same way about the careers we provide - we want to see you excel, on the job and in your personal time. That's why we've put together one of the most comprehensive, flexible benefits packages around, one that offers competitive wages, education and tuition assistance, as well as financial and wellness programs. Our aim is to give you everything you need to get the most out of life by offering you:

. Medical & Dental Coverage . Vision Care Coverage . Life Insurance . Accidental Death & Dismemberment (AD&D) Insurance . Disability Insurance . Medical and Dependent Care Flexible Spending Accounts (FSA) . 403(b) Open Plan . BMC 403(b) Retirement Plan . Earned Time & Extended Sick Leave . Tuition Reimbursement . Employee Assistance Program . Mortgage Assistance Program . MBTA Passes . Parking