Senior Director, Payor Contracting

Location: Boston - Hybrid Organization Summary Community Care Cooperative (C3) is a 501(c)(3) non-profit multi-service organization governed by Federally Qualified Health Centers (FQHCs). Our mission is to leverage the collective strengths of FQHCs to improve the health and wellness of the people we serve. We fulfill two primary business functions for the FQHCs we work with. First, we are an FQHC-led accountable care organization (ACO); second, we are a Management Services Organization (MSO) for FQHCs. As an ACO, we negotiate value-based payor contracts on behalf of our FQHCs, hold and operate those contracts (including fulfilling many compliance, financial management, and population health management functions), and maximize the return to FQHCs of any incentive dollars earned. We are proud to be the market leader in the MassHealth ACO Program. We are the largest Medicaid ACO in Massachusetts, and we operate a variety of business offerings nationwide. As an MSO, we (along with our subsidiary companies, which are also FQHC-led non-profits) provide several financial, operational, and technological services to groups of FQHCs. These services include Epic EHR licensing and implementation; pharmacy operations consulting as well as the building and direct operation of on-site retail pharmacies; billing and credentialing; employer-sponsored insurance; and others. We are a fast-growing, dynamic organization developing new partnerships and programs to improve the health of members and communities, and to strengthen our health center partners. Job Summary Under the direction of the Vice President of Corporate Strategy & ACO Contracting and in partnership with Executive Leadership, the Senior Director, Payor Contracting is responsible for contributing to the organization’s success in managing the organization’s business development efforts in the areas of new value-based contracts and provider contracting. Responsibilities Lead the organization’s payor and provider contracting strategy across multiple markets in partnership with the Executive TeamIdentify opportunities for new value-based contracts on behalf of Federally Qualified Health Center partners and assess both the Company’s and FQHCs capacity to expand into new marketsManage key strategic initiatives related to the organization’s payor contracting strategy, including entry into new geographic areas and marketsDevelop and maintain partner relationships with health plans and provider organizations to meet the organization’s contracting objectivesAssist in the development and management of C3’s business development efforts related to value-based contractingWork with the National Strategy team to research, identify and negotiate value-based contracting opportunities in new markets across multiple payorsNegotiate with payors and oversee the procurement of new payor contracts, principally risk- based contractsPartner with analytics and actuarial teams to understand and predict P&L from new value- based contractsMaintain communications with all stakeholders in the contracting process, including payors, C3 Leadership, and Federally Qualified Health Center partnersUnderstand and communicate contractual requirements and in coordination with leadership, ensure compliance on contract termsConduct due diligence on new contract terms and assist in future gain/loss projectionsAs necessary, work with Operations, Clinical Operations, Quality, Risk Adjustment, and other departments as appropriate to ensure broad-based understanding of contract requirementsAs necessary, assist in the implementation of all new payor contractsParticipate in the monitoring of success in the organization’s value-based contracting effortsSome business travel may be requiredAll other duties as assigned Required Skills Strong analytical skillsHealthcare experience required, including experience with value-based contracts strongly preferredExperience with Federally Qualified Health Centers, including their Federal financing structure, preferredExcellent written and oral communications to a senior leader audience, including the ability to present complex situations and financial analysis in a clear and concise manner Desired Other Skills Track record of facilitating diverse stakeholders toward shared recommendationsFamiliarity with value-based contractsFamiliarity with Federally Qualified Health CentersExperience with anti-racism activities, and/or lived experience with racism is highly preferred Qualifications Bachelor’s Degree requiredPost-graduate degree in health care, business administration, law, or finance field preferred7-10 years of professional experience strongly preferredExperience in health plan and/or provider network contracting required, 5-7 years strongly preferred In compliance with Infection Control practices per Mass.gov recommendations, we require all employees to be vaccinated consistent with applicable law. **