Site: Mass General Brigham Community Physicians, Inc.
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Job Summary
The Senior Manager of Value-Based Contract Modeling serves as the domain owner for financial modeling infrastructure supporting value-based healthcare contracts within Population Health Finance.
This role is responsible for the development, maintenance, and evolution of standardized financial models across all lines of business, including Medicare (Traditional and Medicare Advantage), Medicaid, and Commercial risk arrangements.
The role supports a broad and growing portfolio of value-based payment models, including MSSP, ACO REACH, Medicare Advantage risk contracts, Medicaid programs, and Commercial value-based arrangements.
The position operates under the strategic direction of the Director of Value-Based Performance, who defines modeling priorities, assumptions, and overall financial strategy. This role is accountable for translating that strategy into scalable, well-governed modeling infrastructure and ongoing financial projections.
The role supports financial planning, benchmarking, and settlement analysis across multiple contract types and requires deep expertise in healthcare reimbursement mechanics, benchmark and trend modeling, and scenario-based financial forecasting.
This role partners closely with finance, actuarial, analytics, and clinical leadership to translate cost, utilization, risk, and quality performance analytics into forward-looking financial projections used for strategic decision making.
Essential Functions:
Contract Modeling & Financial Forecasting
• Develop, maintain, and enhance standardized financial models supporting value-based healthcare contracts across Medicare (Traditional and Medicare Advantage), Medicaid, and Commercial lines of business.
• Operationalize modeling assumptions and methodologies defined by Finance leadership into scalable financial models across multiple contract types.
• Model benchmark methodologies, trend assumptions, risk normalization, and shared savings mechanics across diverse payer structures.
• Build scenario-based financial projections to assess upside and downside exposure under varying cost, risk score, and quality performance assumptions across lines of business.
• Support financial planning and forecasting processes for value-based contracts across the enterprise portfolio.
Settlement & Performance Analytics
• Analyze contract settlement results and perform variance analysis relative to projected financial performance.
• Evaluate benchmark gaps and financial performance relative to contract targets.
• Translate cost, utilization, risk, and quality performance analytics into financial projections and modeling inputs.
Contract Strategy Support
• Partner with actuarial, finance, analytics, and clinical leadership to evaluate the financial implications of value-based payment models and contract design.
• Support strategic planning and contract negotiations through financial modeling and sensitivity analyses.
Modeling Infrastructure & Governance
• Establish standardized modeling methodologies across contracts and lines of business.
• Maintain documentation of model assumptions, methodologies, and version control to ensure financial governance and transparency.
• Partner with analytics and data engineering teams to ensure financial models are supported by scalable analytic datasets.
Executive Decision Support
• Prepare financial scenario analyses and projections used to inform executive decision making.
• Provide insights on financial exposure, savings drivers, and performance risks across value-based contracts.
Education:
- Bachelor’s Degree in Finance, Economics, Healthcare Administration, Data Analytics, or related field required.
Master’s Degree in a related field preferred. - Equivalent experience may be accepted in lieu of a degree.
Experience:
- 8 –10+ years of experience in healthcare financial modeling, actuarial analytics, medical economics, or value-based payment analytics.
- Experience supporting Medicare (Traditional and Medicare Advantage), Medicaid, and/or Commercial risk-based payment models strongly preferred.
- Demonstrated experience developing complex financial models and scenario-based projections for healthcare contracts.
- 5 –7 years of previous supervisory or leadership experience required.
Knowledge, Skills & Abilities:
Healthcare Domain Knowledge
- Strong knowledge of healthcare reimbursement methodologies and payment models across Medicare (Traditional and Medicare Advantage), Medicaid, and Commercial risk contracts.
- Understanding of value-based payment models including shared savings, downside risk, capitation, benchmark methodologies, and risk corridors across payer types.
- Experience supporting or analyzing value-based program structures across Medicare ACO models, Medicare Advantage, Medicaid programs, and Commercial value-based arrangements.
- Understanding of risk adjustment methodologies, including CMS-HCC and other payer-specific risk models.
Analytical & Technical Skills
- Advanced financial modeling capabilities in Excel, including development of scenario-based forecasting models and sensitivity analyses.
- Experience building and maintaining complex financial models that incorporate healthcare contract mechanics (e.g., benchmark methodologies, trend, risk adjustment, shared savings structures).
- Proficiency in SQL required;
- Experience working with large healthcare datasets, including claims, enrollment, and risk score data.
- Ability to translate analytic outputs (cost, utilization, risk, quality) into structured financial modeling inputs.
- Experience with data visualization platforms such as Tableau or Power BI to support model outputs and executive reporting preferred, but not required.
Strategic & Communication Skills
- Ability to translate complex financial and analytic concepts into actionable insights.
- Strong communication and presentation skills with the ability to convey technical concepts to both technical and non-technical stakeholders.
- Strong strategic thinking and problem-solving capabilities.
Additional Job Details (if applicable)
Remote
399 Revolution Drive
40
Regular
Day (United States of America)
Pay Range
$117,707.20 - $171,204.80/Annual
Grade
8
At Mass General Brigham, we believe in recognizing and rewarding the unique value each team member brings to our organization. Our approach to determining base pay is comprehensive, and any offer extended will take into account your skills, relevant experience if applicable, education, certifications and other essential factors. The base pay information provided offers an estimate based on the minimum job qualifications; however, it does not encompass all elements contributing to your total compensation package. In addition to competitive base pay, we offer comprehensive benefits, career advancement opportunities, differentials, premiums and bonuses as applicable and recognition programs designed to celebrate your contributions and support your professional growth. We invite you to apply, and our Talent Acquisition team will provide an overview of your potential compensation and benefits package.
6010 Mass General Brigham Community Physicians, Inc. is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religious creed, national origin, sex, age, gender identity, disability, sexual orientation, military service, genetic information, and/or other status protected under law. We will ensure that all individuals with a disability are provided a reasonable accommodation to participate in the job application or interview process, to perform essential job functions, and to receive other benefits and privileges of employment. To ensure reasonable accommodation for individuals protected by Section 503 of the Rehabilitation Act of 1973, the Vietnam Veteran’s Readjustment Act of 1974, and Title I of the Americans with Disabilities Act of 1990, applicants who require accommodation in the job application process may contact Human Resources at (857)-282-7642.
Mass General Brigham Competency Framework
At Mass General Brigham, our competency framework defines what effective leadership “looks like” by specifying which behaviors are most critical for successful performance at each job level. The framework is comprised of ten competencies (half People-Focused, half Performance-Focused) and are defined by observable and measurable skills and behaviors that contribute to workplace effectiveness and career success. These competencies are used to evaluate performance, make hiring decisions, identify development needs, mobilize employees across our system, and establish a strong talent pipeline.
