What are the responsibilities and job description for the Dir, Value Based Care position at TriWest Healthcare Alliance?
Responsible for designing, implementing, and expanding a Value Based Care strategy in support of health care cost optimization and quality goals. Oversees a portfolio of initiatives related to Value Based Care including program development, provider engagement, contracts, continuous performance monitoring, and program refinement. Leverages recognized project management best practices and analytical expertise with the full backing of corporate project sponsors, ensuring the successful execution of initiatives. Collaborates with a highly proficient team of ePMO staff, program/project managers, consultants and business analysts across the company. This position plays a pivotal role in optimizing healthcare services. Position reports to the Vice President of Network Strategy and Value Based Care.
Education & Experience
Required:
- Bachelor’s degree in healthcare or business administration, Management Information, or related field; or equivalent background and experience
- Experience with healthcare analytics and provider networks
- Five years of experience at a management level in a healthcare provider network performance management environment
- Demonstrated large cross-functional project/program implementation and deployment experience
- Experience designing provider incentive and discount programs and use of enabling healthcare technology
- Experience with value-based programs, including focus on quality, affordability, and risk adjustment
- Deep understanding of various provider reimbursement models, ranging from pay for performance to capitation and global-risk
- Master’s degree in healthcare or business-related discipline or equivalent background and experience negotiating provider network and value-based healthcare delivery contracts, including the development of new relationships and opportunities that achieve desired cost optimization targets
- Experience in government programs (e.g., VA/DoD, Veteran Affairs, Medicare, Medicaid)
- Experience operating value-based care programs within the HCPLAN or CMS framework(s)
- High competency use of MS Office applications including Project, Visio, Excel, PowerPoint, Word, and other modern project management process tools
- Veteran or military family member
Key Responsibilities
Design and implement a comprehensive Value Based Network strategy to align with the organization's goals, ensuring healthcare cost and quality objectives are achieved- Continuously expands value based care program to increasingly more complex models
- Develops sophisticated health care economics models to evaluate the efficacy of various value based care scenarios and models
- Monitors industry trends related to value based care, including other payer programs and government led programs and demonstrations
- Provides experience based input and guidance to the Network Strategy team on matter related to network discounts, including targets, trends, and risks to defined goals
Researches, identifies, and reports potential risks and issues related to value based care programs to organizational leadership- Leverage relationship building skills throughout program development, deployment, and transition to operational excellence
- Manage project schedules and task details; utilize project management tools and reports appropriately
- Manages relationships with key value based technology vendors as well as Network Subcontractors
- Utilizes data and associated analytics to inform decision-making and strategy development for continuous growth and expansion of value based care programs
- Assists in the negotiation and execution of value based care provider contracts
- Analyzes and reports on the impact of change orders, controls letters, and other directives with implications for TriWest’s portfolio of value based care programs
Competencies
Communication / People Skills: Ability to influence or persuade others under positive or negative circumstances; adapts to different styles; listens critically; collaborates.
Computer Literacy: Ability to function in a multi-system Microsoft environment using Word, Outlook, Excel, PowerPoint, TriWest Intranet, the Internet, and department software applications.
Independent Thinking / Self-Initiative: Critical thinkers with ability to focus on things which matter most to achieving outcomes; commitment to task to produce outcomes without direction and to find necessary resources.
Information Management: Ability to manage large amounts of complex information easily, communicates information clearly, and draws sound conclusions.
High Intensity Environment: Ability to function in a fast-paced environment with multiple activities occurring simultaneously while maintaining focus and control of workflow.
Leadership: Successfully manages different styles of employees; provides clear direction and effective coaching.
Multi-Tasking / Time Management: Prioritizes and manages actions to meet changing deadlines and requirements within a high volume, high stress environment.
Organizational Skills: Ability to organize people or tasks, adjust to priorities, learn systems, within time constraints and with available resources; detail-oriented.
Problem Solving / Analysis: Ability to solve problems through systematic analysis of processes with sound judgment; has a realistic understanding of relevant issues.
Team-Building / Team Player: Influences the actions and opinions of others in a positive direction and build group commitment.
Technical Skills: Knowledge of budgeting process and staff planning concepts.
Working Conditions
Working Conditions:
- Availability to accommodate working hours across multiple time-zones
- Works within a hybrid office and remote home environment
Company Overview
Taking Care of Our Nation’s Heroes.
It’s Who We Are. It’s What We Do.
Do you have a passion for serving those who served?
Join the TriWest Healthcare Alliance Team! We’re On a Mission to Serve®!
Our job is to make sure that America’s heroes get connected to health care in the community.
At TriWest Healthcare Alliance, we’ve proudly been on that important mission since 1996.
Benefits
We’re more than just a health care company. We’re passionate about serving others! We believe in rewarding loyal, hard-working people who are willing to learn as they grow. TriWest Healthcare Alliance values teamwork. Join our team, fulfill your responsibilities, and you may also be considered for frequent pay raises, overtime opportunities to earn even more, recognition and reward programs, and much more. Of course, we also offer a comprehensive and progressive compensation and benefits package that includes:
- Medical, Dental and Vision Coverage
- Generous paid time off
- 401(k) Retirement Savings Plan (with matching)
- Short-term and long-term disability, basic life, and accidental death and dismemberment insurance
- Tuition reimbursement
- Paid volunteer time
Equal Employment Opportunity
TriWest Healthcare Alliance is an equal employment opportunity employer. We are proud to have an inclusive work environment and know that a diverse team is a strength that will drive our success. To that end, TriWest strives to create an inclusive environment that cultivates and supports diversity at every organizational level, including hiring and retaining a diverse workforce, and we highly encourages candidates from all backgrounds to apply. Applicants are considered for positions without discrimination on the basis of race, color, religion, sex, sexual orientation, gender identity, national origin, age, disability or any other consideration made unlawful by applicable federal, state, or local laws.
