Executive Director, Value-Based Reimbursement and Strategic Procurement

4 days ago

Dayton, Ohio, United States CareSource Full time
Job Summary:

The Executive Director, Value-Based Reimbursement and Strategic Procurement, will be responsible for developing, managing, and executing an enterprise value-based reimbursement strategy that will improve member health and quality outcomes, accomplish cost savings/quality affordability initiatives (QAI), and support all markets and lines of business to include VBR program development and design, monitoring and performance management, contract negotiations and VBR system administration.

Key Responsibilities:
  • Develop and contract strategies and activities with vendors, providers, and medical service organizations to include advanced payment models, performance guarantees, risk, and shared savings arrangements.
  • Provide support to Corporate Compliance and Vendor Risk and Oversight for regulatory compliance requirements of delegated vendors/entities and development of a comprehensive inventory of contracts and delegated vendors; assist in determining strategy/solution to automate process.
  • Manage vendor portfolio from a strategic vendor relationship management perspective; refine procurement model and processes with input from key business partners.
  • Establish and monitor targets for supplier diversity and economic inclusion.
  • Provide leadership, mentoring, and development of staff; adhere to all company Human Resources practices.
  • Assist in determination of benchmarks, goals, and outcomes for defined programs, informed by analytics and evidence-based practice.
  • Ensure a schedule of periodic reviews of top-tier vendors to create mutually beneficial business relationships in which all contract terms and conditions are being met along with any regulatory requirements.
  • Establish, maintain, and acquire targeted cost savings associated with vendor, provider, VBR negotiations, and best practices.
  • Provide optimization through reporting dashboards based upon targeted best practice metrics.
Requirements:
  • Bachelor's degree in business or related discipline or equivalent years of relevant work experience is required.
  • Master's degree is preferred.
  • Minimum of seven (7) years of value-based reimbursement or value-based care program management required.
  • Minimum of five (5) years of senior leadership experience with responsibility for development and implementation of strategies and plans in support of an organization is required.
  • Experience negotiating large/complex external vendor and provider contracts are required.
  • Healthcare and/or insurance experience is preferred.
Competencies, Knowledge, and Skills:
  • Extraordinary relationship building, communication, and presentation skills.
  • Demonstrated business collaboration and customer relationship management skills.
  • Demonstrated analytical and problem-solving skills.
  • Outstanding verbal and written communication skills.
  • Effective negotiation and strategic sourcing skills.
  • Knowledge of project management and vendor management practices and industry trends.
  • Ability to manage, mentor, and lead a team.
  • Proven ability to develop effective relationships at all levels of the company.
  • Ability to learn and understand complex regulatory requirements.
  • Demonstrated strategic leader with strong relationship building skills.
  • Results-oriented, with strong analytical, facilitation, and strategic planning skills.
  • Financial, analytical, prioritization, and problem-solving skills.

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