Value-Based Care and Contracting Director

2 weeks ago


Southfield, Michigan, United States MyCareer Full time
About the Role

At MyCareer, we're seeking a highly skilled Value-Based Care and Contracting Manager to drive our strategies for optimizing value-based reimbursement opportunities and managing payer relationships.

Job Overview

The successful candidate will be responsible for negotiating contracts, overseeing Accountable Care Organization (ACO) initiatives, and ensuring compliance with healthcare regulations. This role requires close collaboration with various internal teams and external stakeholders to enhance financial performance, improve patient outcomes, and maintain regulatory compliance.

Key Responsibilities
  1. Analyze financial and operational data to help the organization stay competitive in the evolving healthcare landscape.
  2. Develop and execute strategies for value-based reimbursement, working alongside clinical and financial teams to align objectives and identify areas for improvement.
  3. Negotiate contracts with payers, ensuring agreements are beneficial and in line with regulatory requirements.
  4. Oversee ACO programs, focusing on performance management, compliance, and enhancing the quality of care and patient satisfaction.
  5. Establish policies and procedures to ensure compliance with federal, state, and local laws related to value-based care and ACO operations.
Requirements

The ideal candidate will have a Bachelor's degree in healthcare administration, business, finance, or a related field, with a preference for candidates holding a Master's degree. A minimum of five years of experience in healthcare administration, value-based reimbursement, payer relations, or ACO management is required.

Candidates should possess strong knowledge of value-based care models, excellent communication and negotiation skills, and the ability to balance multiple priorities in a dynamic setting. Problem-solving skills, familiarity with healthcare regulations, and experience working in a matrix organization will also be important for success in this role.



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