Strategic Payer Operations Leader
1 week ago
The Vice President, Payer Strategy Integration is a critical role that drives the integration and alignment of managed care payer strategy with CHI's strategic objectives. This position is responsible for leading 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.
Key Responsibilities- Lead national Payer Strategy and Operations staff activities across CHI, including direct oversight of Managed Care teams/functions.
- Implement and monitor the success of CHI's national payer strategies to drive sustainable financial performance.
- Develop and maintain value-based contracting strategies and guardrails that lower total cost of care, improve population health, and drive growth & sustainable financial performance.
- Oversee Managed Care contract maintenance, access, and operational management processes and activities.
- Monitor CMS reimbursement & payment policy changes and provide strategic insight into their impact on CHI managed care contracts & payer strategies.
- Collaborate and align 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.
- Bachelor's Degree required in a related discipline; Master's Degree strongly preferred.
- Ten years of progressive leadership responsibility and experience in large healthcare organizations and/or integrated healthcare delivery systems.
- Five years of 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.
CLevelCrossing is an equal opportunity employer. We offer a competitive salary and benefits package, as well as opportunities for professional growth and development.
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