AVP, National Value-Based Contracting
RemoteUnited States
Job Summary
Lead strategy and leadership for value-based contracting (VBC) activities, valuating, negotiating, and expanding the organization's VBC portfolio across the enterprise. Identify and negotiate contracts that lower the total cost of health care while managing complex external partnerships and assessing risks related to state regulations and data infrastructures. Define and implement the enterprise-wide VBC operating model, creating standards for analytics and reconciliation processes with providers. Collaborate with network, medical economics, risk adjustment, finance, and IT teams to develop new value-based partnerships and align disparate stakeholders around a unified strategy. Manage multiple cross-enterprise projects, provide monthly executive reporting, and build a high-performance team through hiring, coaching, and talent retention. Some travel to markets may be required (up to 15%).
Required Qualifications
- At least 10 years of experience in network contracting
- At least 8 years experience in value-based care (VBC) contracting
- At least 5 years of management/leadership experience
- Extensive experience in the health insurance industry
- Expert level knowledge regarding reimbursement methodologies for value-based contracts, across all lines of business (Medicaid, Medicare, Marketplace)
- Strong experience with various managed health care provider compensation methodologies
- Excellent negotiation and relationship building capabilities
- Ability to navigate complex regulatory environments
- Data-driven decision-making skills, and strong analytical abilities
- Strong organizational skills and attention to detail
- Ability to work cross-functionally with internal/external stakeholders in a highly matrixed organization, and influence business decisions
- Ability to manage multiple tasks and deadlines effectively
- Strong project management skills
- Excellent verbal and written communication skills, and ability to present at an executive level
- Microsoft Office suite and applicable software programs proficiency
Desired Qualifications
- Project Management Professional (PMP) or Six Sigma green belt certification
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