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Vice President Payer Strategy Operations

3 months ago

Englewood, Colorado, United States CLevelCrossing Full time
Vice President Payer Strategy Operations

Location
Englewood, CO, United States
Posted on
Jan 05, 2018
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Vice President Payer Strategy Operations','Full-time','Professional Non-Clinical','1','1','80','80','Occasional','Occasional','COLORADO-ENGLEWOOD-DENVER INVERNESS','','*Job Summary / Purpose

The Vice President, Payer Strategy Integration is responsible for integrating and aligning managed care payer strategy with CHI's strategic objectives, including national payer contracting strategies and standards, value-based contracting strategy and oversight, contract management and operations processes, government reimbursement trends and projections and merger/acquisition/divestiture transactions.

This role leads the overall integration and alignment of Payer Strategy & Operations across the enterprise, including Division Payer Strategy and Contracting, Revenue Cycle Management, Finance, Government Reimbursement, Legal and Business Development.

The Vice President, Payer Strategy Integration positions CHI for sustainable financial performance through strategic alignment and integration of managed care payer strategy and operations with CHI's strategic objectives.

Essential Key Job Responsibilities

  • National CHI leader responsible for strategic and operational integration of managed care payer strategy.
Leads national Payer Strategy and Operations staff activities across CHI, to include direct oversight of the following Managed Care teams/functions:
National Payer Strategy, Value Based Contracting Strategy, Contract Management and Operations, CHI Managed Care Integration & Alignment.

  • Implements and monitors success of CHI's national payer strategies to drive sustainable financial performance.
  • Develops and maintains value-based contracting strategies and guardrails that lower total cost of care, improve population health and drive growth & sustainable financial performance.
  • Oversees Managed Care contract maintenance, access and operational management processes and activities.
  • Monitors CMS reimbursement & payment policy changes and provides strategic insight into impact to CHI managed care contracts & payer strategies.
  • Leads research, analysis and payer strategy development activities to support successful merger/acquisition/divestiture transactions.
  • Collaborates and aligns with national and market-based Payer Strategy & Operations, Revenue Cycle, Finance, Government Reimbursement, Legal, and Business Development to maximize the value of CHI's managed care payer contracts.
12-18 month expectations

This position is responsible for integrating and aligning managed care payer strategy with CHI's strategic objectives, including national payer contracting strategies and standards, value-based contracting strategy and oversight, contract management and operations processes, government reimbursement trends and projections and merger/acquisition/divestiture transactions.

Success will be evident in revenue generation achieved through managed care payer contracting, value-based contract performance, effective contract management and operations procedures, and the organization's ability to successfully complete merger/acquisition/divestiture transactions while delivering affordable access and service excellence.

Key success indicators for the first 12-18 months of this role:

Develop and implement national payer strategies that drive revenue generation;
Enhance national payer contracting standards, guidelines, approval and exception management processes;
Implement effective contract management and operations policies and procedures that maximize the value of CHI managed care payer contracts;
Establish enterprise value-based contracting strategy playbook and implementation guardrails;
Provide strategic insights on CMS reimbursement & payment policy changes impacting CHI managed care contracts & payer strategies;
Deliver research, analysis and payer strategy insight to support successful CHI merger/acquisition/divestiture transactions;
Integrate and align managed care payer strategy with CHI strategic objectives through collaboration with Revenue Cycle, Finance, Government Reimbursement, Legal, and Business Development;
Demonstrate concrete and relevant revenue linkages between national payer contracts, value generation to customers, and CHI Mission objectives;
Identify, document and translate emerging successes and lessons learned into subsequent phases of this work.

','*Education:

Bachelor's Degree required in related discipline; Master's Degree strongly preferred

Experience:
Ten years progressive leadership responsibility and experience in large healthcare organizations and/or integrated healthcare delivery systems
Five years strategic management of healthcare pricing, contract negotiation, and healthcare economics in a complex, national or multi-regional healthcare system or health insurance environment
Demonstrated success in leading, implementing, and managing financial performance of payer contracts
Demonstrated ability to work effectively in a matrix organization
Demonstrated ability to effectively drive strategic transformation work
','We're an equal opportunity employer. All applicants will be considered for employment without attention to race, color, religion, sex, sexual orientation, gender identity, national origin, veteran or disability status.','2017-R0144269','Catholic Health Initiatives - National Office','Vice President Payer Strategy Operations:
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External Title,AnswerValue:
Regional Vice President of Growth and Development - WEST -REMOTE,VerityZone:

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