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In-House
Attorney
Health Care
Litigation - Whistleblower - CFTC
Min 10 yrs required
Staff VP Payment Innovation Reporting/Tools and Payment Models Duties: Develop total value payment models that incentivize improvements in health care quality and outcomes while reducing unnecessary cost and resource use associated with care delivery. Oversee the complementary tools and applications that support population health management, and make cost and quality information available to physicians and their patients. Leads the development and maintenance of shared savings and risk models that evaluate the performance of providers across the domains of cost, resource use, and quality. Leads the payment innovation reporting strategy, which includes developing and executing against the three year roadmap. Accountable for the end-to-end creation of Payment Innovation’s reporting solutions; this includes user story conception, requirements gathering, prototype design, and testing. Oversee Company’s Data Exchange process for sharing information (e.g., claims, member, and provider) with large provider systems. Collaborates with Health Care Analytics and Provider Engagement and Contracting (PE&C) management to ensure payment innovation reporting solutions and tools appropriately support PE&C initiatives and programs. Monitors key program financial metrics. Represents the Vice President Payment Innovation at symposiums and key meetings with regulators, provider groups, customers, and internal business areas. Hires, trains, coaches, counsels, and evaluates performance of direct reports.
Qualification and Experience
Qualifications: A BA/BS in a related field; 10 years of progressive experience in managed care or integrated health services with understanding of reimbursement methods including Fee For Service (FFS), Pay for Performance (P4P), bundles, capitation and global budgets; as well as strong understanding of web based reporting and product development (emphasis on agile methodology) or any combination of education and experience, which would provide an equivalent background. MBA, J.D. degree or MHA strongly preferred.
Requisition ID: 89347
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