1 Senior Director Value-Based Contracts Job in Florida, NY
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Florida Blue (Blue Cross and Blue Shield of Florida)
Florida, NY | Full Time
$192k-247k (estimate)
1 Month Ago
Senior Director Value-Based Contracts
$192k-247k (estimate)
Full Time
1 Month Ago
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Florida Blue (Blue Cross and Blue Shield of Florida) is Hiring a Senior Director Value-Based Contracts Near Florida, NY
Job DescriptionThe successful candidate must be able to translate strategy to action. The individual is someone who sees a new Value-based Care ("VBC") business model and knows how to solve/implement it. Frequently, this leader must partner with the client/provider organization utilizing his/her VBC subject matter expertise to build new business models, operating models, and care models to succeed in our continued transformation towards value. The Sr. Director, in conjunction with Vice President and leadership team, must deliberately build an internal culture where the intersection of quality of care, affordability, and patient experience is the highest priority. This includes consultations with physician practices, account management with business stakeholders, and the project management of internal and external resources to meet deliverable expectations.
Job Duties Include But Are Not Limited To
To support your wellbeing, comprehensive benefits are offered. As an employee, you will have access to:
To support your financial wellbeing, we offer competitive pay as well as opportunities for incentive or commission compensation. We also conduct regular annual reviews with pay for performance considerations for base pay increases.
Annualized Salary Range: $144,000 - $234,000
Typical Annualized Hiring Range: $144,000 - $180,000
Final pay will be determined with consideration of market competitiveness, internal equity, and the job-related knowledge, skills, training, and experience you bring.
We are an Equal Opportunity/Protected Veteran/Disabled Employer committed to creating a diverse, inclusive and equitable culture for our employees and communities.
About UsAt GuideWell, we are committed to making diversity, equity and inclusion part of everything we do. We believe in hiring people who represent the communities we serve while creating a workplace that encourages a sense of belonging for everyone, no matter who you are or where you come from.
From students to former military to seasoned professionals, our family of mission-based companies are stronger because of the unique talents and skills of our employees. We believe everyone’s contribution has the power to help people and communities achieve better health. Find your new team today.
About The TeamFlorida Blue, A GuideWell Company, has been providing health insurance to residents of Florida for 75 years. Driven by its mission of helping people and communicating to achieve better health, the company serves more than five million health care members across the state. We are looking for exceptional people who will bring our mission to life and succeed by putting the members first.
Job Duties Include But Are Not Limited To
- Advances the company strategy to adopt value-based payment models
- Develops competencies to understand rules and regulations of value-based programs
- Develops and implements network configurations and incentive-based models as appropriate to deliver on quality and high-performing networks to support business objectives for Medical Loss Ratios (MLR) targets, growth and income results
- Facilitates and leads the strategic planning process for the development, implementation and management of value-based networks focused on favorable unit cost performance as well as overall medical costs
- Formulates and implements alternative reimbursement methodologies for various provider types that ensures departmental and enterprise goals are achieved
- Ensures compliance with value based contracting pricing guidelines as well as familiarity with alternative payment models (APM) framework, bundled payments, condition-specific capitation, hospital physician gain sharing, and pay for performance options
- Leads teams to develop, negotiate and manage complex Value Based and Alternative Payment Model (APM) relationships
- Collaborates with leadership on selection and ongoing analysis of potential VBC programs and partners
- Defines targets both financially and qualitatively with leadership
- Facilitates implementation and executes on value-based initiatives
- Serves as the business lead for all IT projects associated with Value Base Network arrangements, including the development of the strategy and business requirements to support value-based program expansion
- Serves as business initiative owner for Association and Industry VBC committees
- Oversees the negotiation, implementation and management of VBC agreements
- Monitors performance throughout program’s term and collaborates with the Value Base Coaching team to implement effective strategies and tactics to improve VBC relationship
- Develops and manages Value Base Contract scorecard to support departmental and enterprise goals
- Coordinates with internal and external partners to reconcile data for both financial and qualitative purposes
- Serves as business sponsor for all outside vendors engagements; defines requirements and scopes of work
- Develops and maintains relationships with clients and project stakeholders
- Conducts assessments to identify physician practice value-based readiness, including strengths, weaknesses, opportunities, and threats
- Measures business performance; identifies and quantifies KPI drivers, risks and opportunities for business performance and define solutions to mitigate risks and leverage opportunities for the benefit of VBC clients
- Recruits, motivates, retains, develops and leads a team of professionals to achieve target results
- Works within a team environment
- Establishes contacts and enhances relationships with healthcare professionals, associations, advisory groups and community task forces by exhibiting knowledge, technical competency, reliability and professionalism
- Identifies opportunities to mentor and coach others to achieve results, and is open to cultural and geographic diversity
- Manages time, territory, costs and administrative requirements by effectively planning and carrying out plans to ensure that support activities are achieved at reasonable costs
- Related Bachelor’s degree or additional related equivalent work experience Management, Business Administration, Health Care Administration or closely related field
- 8 years related work experience. Experience Details: Provider Management or Health Plan management leadership experience
- 5 years management/supervisory experience
- Both tactical, and strategic experience working within healthcare provider networks as well as large group physician practice operations. Health system experience is a plus
- Expert level of proficiency with provider / facility / ancillary contract reimbursement methodologies
- Expert knowledge of business processes that impact physician practice, facility, and/or ancillary provider operational results
- Knowledge of healthcare practice management and electronic medical records systems
- Demonstrated management skills that include making effective and efficient decisions and prudent judgment to achieve long-range and short-term goals
- Ability to bring together a variety of functions in a spirit of strategic harmony and with a single-minded purpose
- Solid project management skills and ability to produce high-quality and timely deliverables within a project-focused environment. Capable of managing multiple priorities simultaneously
- Experience working with large data sets, creating ad hoc reports, and presentations
- Demonstrates effective proactive problem-solving ability while maintaining compliance protocols
- Solid understanding of value-based healthcare economics, including knowledge of impact to physician practice and managed care environments
- Strong consulting skills and ability to facilitate problem resolution process
- Experience working within the healthcare industry, particularly in the delivery system (hospital clinic, physician practice)
- Practice Management
To support your wellbeing, comprehensive benefits are offered. As an employee, you will have access to:
- Medical, dental, vision, life and global travel health insurance;
- Income protection benefits: life insurance, Short- and long-term disability programs;
- Leave programs to support personal circumstances;
- Retirement Savings Plan includes employer contribution and employer match;
- Paid time off, volunteer time off, 10 holidays and two flexible Well-Being days
- Additional voluntary benefits available; and
- A comprehensive wellness program
To support your financial wellbeing, we offer competitive pay as well as opportunities for incentive or commission compensation. We also conduct regular annual reviews with pay for performance considerations for base pay increases.
Annualized Salary Range: $144,000 - $234,000
Typical Annualized Hiring Range: $144,000 - $180,000
Final pay will be determined with consideration of market competitiveness, internal equity, and the job-related knowledge, skills, training, and experience you bring.
We are an Equal Opportunity/Protected Veteran/Disabled Employer committed to creating a diverse, inclusive and equitable culture for our employees and communities.
About UsAt GuideWell, we are committed to making diversity, equity and inclusion part of everything we do. We believe in hiring people who represent the communities we serve while creating a workplace that encourages a sense of belonging for everyone, no matter who you are or where you come from.
From students to former military to seasoned professionals, our family of mission-based companies are stronger because of the unique talents and skills of our employees. We believe everyone’s contribution has the power to help people and communities achieve better health. Find your new team today.
About The TeamFlorida Blue, A GuideWell Company, has been providing health insurance to residents of Florida for 75 years. Driven by its mission of helping people and communicating to achieve better health, the company serves more than five million health care members across the state. We are looking for exceptional people who will bring our mission to life and succeed by putting the members first.
Job Summary
JOB TYPE
Full Time
SALARY
$192k-247k (estimate)
POST DATE
07/17/2024
EXPIRATION DATE
08/14/2024
WEBSITE
ewgajax.com
SIZE
<25
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