Director, Enterprise Value Based Reimbursement Strategy(Required Experience In VBR, Preferred Experience In Managed Care)

CareSource•Dayton, OH

24d

About The Position

Job Summary: The Director, Enterprise Value Based Reimbursement (VBR) Strategy serves as the enterprise-wide VBR strategy lead to all markets and lines of business. The Director will lead ongoing engagements with market leadership to build VBR strategy plans, collaborate with state partners around VBR strategy, and coordinate VBR program solutions for markets. Essential Functions: Support the development and execution of both enterprise-level and market-specific value-based reimbursement (VBR) strategies to enhance organizational alignment and effectiveness across various markets and lines of business. Collaborative with market leadership on VBR strategies that address specific requirements for Request for Proposals (RFPs), and continue collaboration post-RFP to build and implement effective VBR program plans. Partner closely with market leadership to ensure compliance with state-level VBR requirements and commitments by leveraging appropriate strategies and programs to meet regulatory expectations. Build strong, influential, and collaborative relationships with key internal stakeholders and external partners to shape and drive VBR program strategy. Lead discussions with healthcare providers and organizations that are instrumental in fostering enterprise-wide VBR partnerships. Continuously evaluate and adjust VBR programs to ensure they remain in alignment with enterprise objectives, enhancing their impact and relevance. Oversee the development and operationalization of policies, standards, benchmarks, performance metrics, and quality control mechanisms to ensure high standards in VBR strategy execution. Maintain up-to-date knowledge of regulatory changes and market-specific performance standards to guarantee compliance and ensure timely execution. Lead negotiations and contract discussions with healthcare providers identified as providing innovative care solutions that support a comprehensive national VBR approach. Provide leadership, mentorship, and professional development opportunities to staff, fostering a supportive environment that encourages growth and excellence in performance. Perform any other job related duties as requested.

Requirements

Bachelor's degree in management, healthcare management or related field is required
Equivalent years of relevant work experience may be accepted in lieu of required education
Five (5) years of experience in value-based reimbursement design, methodologies and/or VBR contracting, data analysis, reporting, or data support is required
Three (3) years of Provider contracting or Provider relations is required
Five (5) years of leadership/management experience is required
Proficient in Microsoft Office to include Word, PowerPoint, Access - advanced proficiency in Excel
Excellent team facilitation skills
High level of analytic skills for solving problems
Excellent oral, written, and interpersonal communication skills
Strong knowledge of Value Based Contracting methodologies and operations and/or experience in health care quality
Knowledge of provider contracting and familiarity with provider network operations
Critical listening and thinking skills
Problem solving skills
Attention to detail and work plan creation, implementation, and evaluation
Business acumen and strategic thinking skills, yet able to execute tactically
Strong relationship management skills and ability to maintain and build strong working relationships in a matrix environment

Nice To Haves

Master's degree is preferred
Preferred Experience In Managed Care

Responsibilities

Support the development and execution of both enterprise-level and market-specific value-based reimbursement (VBR) strategies to enhance organizational alignment and effectiveness across various markets and lines of business.
Collaborative with market leadership on VBR strategies that address specific requirements for Request for Proposals (RFPs), and continue collaboration post-RFP to build and implement effective VBR program plans.
Partner closely with market leadership to ensure compliance with state-level VBR requirements and commitments by leveraging appropriate strategies and programs to meet regulatory expectations.
Build strong, influential, and collaborative relationships with key internal stakeholders and external partners to shape and drive VBR program strategy.
Lead discussions with healthcare providers and organizations that are instrumental in fostering enterprise-wide VBR partnerships.
Continuously evaluate and adjust VBR programs to ensure they remain in alignment with enterprise objectives, enhancing their impact and relevance.
Oversee the development and operationalization of policies, standards, benchmarks, performance metrics, and quality control mechanisms to ensure high standards in VBR strategy execution.
Maintain up-to-date knowledge of regulatory changes and market-specific performance standards to guarantee compliance and ensure timely execution.
Lead negotiations and contract discussions with healthcare providers identified as providing innovative care solutions that support a comprehensive national VBR approach.
Provide leadership, mentorship, and professional development opportunities to staff, fostering a supportive environment that encourages growth and excellence in performance.
Perform any other job related duties as requested.