Executive Director, Payment Transformation

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🔥 1 minute ago

🌽 Illinois, Montana, +3 more states – Remote

🌽 Illinois – Remote 🦬 Montana – Remote 🌶️ New Mexico – Remote 🌪️ Oklahoma – Remote 🤠 Texas – Remote

💵 $161.5k - $299.7k / year

⏰ Full Time

🔴 Lead

👔 Director

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Health Care Service Corporation

WebsiteLinkedInAll Job Openings

10,000+ employees

Health Care Service Corporation serves nearly 23 million people across the United States through its portfolio of health benefit solutions.

📋 Description

• Overseeing enterprise payment transformation efforts including payment strategies and model design, and alternative payment model implementation and end-to-end VBC administration. • Responsible for VBC strategy including design of new VBC models and enhancement of existing VBC models across all Lines of Business and States and National Network Strategy and Integration. • Direction and expansion of Value Based Care provider contracting; development, direction and management of competitive provider pricing models, medical economic opportunity analysis and Performance Based Reimbursement programs. • Assessment of new network VBC target opportunities and value propositions; VBC strategy design, governance and execution. • Development, promotion and presentation of network advantages/strengths. • Oversee VBC analytics, provider performance reporting and platforms as well as all payment administration systems including data integration, payment platforms delivery and technical releases, year around operations, audit oversight, and issue resolution.

🎯 Requirements

• Bachelor’s degree and 10 years managed care experience at the health plan level or hospital/health system level, including direct responsibility for strategic network and financial management operations OR Masters Degree and 8 years of experience in a combination of healthcare consulting and/or data insights and finance relating to healthcare information • 7 years management experience • Leadership skills to lead team and drive results by working across departments. • Experience with complex managed care concepts in a matrix management environment. • Experience developing solutions/systems to support network development activities and Value Based Care programs. • Expertise and/or demonstrated experience with business intelligence tools; designing, reporting and delivering analytical solutions; data management and warehousing, and the strategic use of information. • Experience with enterprise-wide project coordination, project management, facilitation, presentation, and leadership experience. • Experience in implementing large, complex multi-functional business systems into operations • Experience with project management involving multi-functional team members. • Experience in interacting and influencing diverse interest groups including providers, regulators, other health plans, members and staff. • Knowledge of State and Federal laws and regulations. • Knowledge of network management trends and innovations. • Clear and concise verbal and written communication skills including interpersonal and presentation skills. • Experience with the insurance environment including trends in philosophy, theory, and applications concerning all products and services.

🏖️ Benefits

• Health and wellness benefits • 401(k) savings plan • Pension plan • Paid time off • Paid parental leave • Disability insurance • Supplemental life insurance • Employee assistance program • Paid holidays • Tuition reimbursement • Other incentives