Director, Enterprise Value Based Reimbursement Strategy – Required Experience in VBR, Preferred Experience in Managed Care

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CareSource

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Healthcare Insurance

CareSource is a health services company focused on providing affordable health insurance and healthcare solutions. It offers a wide range of plans including Medicaid, Marketplace, and Medicare Advantage, targeting low-income adults, families, children, pregnant women, elderly adults, and people with disabilities. Additionally, CareSource provides members with resources for COVID-19 support, dental, vision, and hearing benefits, as well as pharmacy services. The company emphasizes easy access to healthcare management through online platforms and a mobile app.

1001 - 5000 employees

Founded 30+ years

⚕️ Healthcare Insurance

📋 Description

• Serve as the enterprise-wide VBR strategy lead to all markets and lines of business • Lead ongoing engagements with market leadership to build VBR strategy plans • Collaborate with state partners around VBR strategy • Coordinate VBR program solutions for markets • Support the development and execution of enterprise-level and market-specific VBR strategies • Own collaborations post-RFP to build and implement effective VBR program plans • Partner closely with market leadership to ensure compliance with state-level VBR requirements • Build relationships with key stakeholders and external partners to shape VBR program strategy • Oversee the development of policies, standards, benchmarks, performance metrics, and quality control mechanisms • Lead negotiations and contract discussions with healthcare providers • Provide leadership and mentorship to staff.

🎯 Requirements

• Bachelor's degree in management, healthcare management, or related field is required • Master's degree is preferred • 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 • 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 • Must be fluent in English.

🏖️ Benefits

• Comprehensive total rewards package • Bonuses tied to company and individual performance • Health insurance • Professional development opportunities