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SVP of Payer Strategy Apply to This Job

Company: ExecuNet
Location: Burlington
Posted on: February 25, 2021

Job Description:

Remarks: Company is seeking a payer executive to support its commitment to value-based care and to lead the payer strategy for Company including all its constituent Physicians (through a Clinically Integrated Network), and Hospitals and Home Health companies. The Payer Strategy Executive is a key member of the Company Senior leadership team, responsible for conceptualizing, developing and executing commercial, Medicare and other public payer strategies that support the system 's business objectives and meet the goals of all stakeholders. This executive leads the departments and consultants responsible for contract negotiations, payer market review and analysis, identifying and summarizing provider competitive intelligence, managing the legal and operational, and contract finance aspects of all system payer arrangements. As early adopters of value-based contracts, Company is looking for an experienced executive who can advance our work in this area including exploration of collaborations with payers. Company has a large public payer portfolio that will also fall under the purview of this position and requires a coordinated strategy. The SVP will oversee key payer strategy development to enable payer alignment with system strategic goals and negotiations, addressing both address value-based models as well as FFS models for referral business. The position will have significant revenue responsibilities and will require a high level of understanding of healthcare financing, delivery as well as the ability to think strategically and offer innovative solutions to complex challenges. Responsibilities:

  • The position provides strategic thought leadership to Company, it 's CIN 's and its constituent entities regarding value-based and fee-for-service contracting initiatives. These responsibilities need to be carried out with a high value placed on process buy-in, needs and reactions of constituencies, consensus, and expectation management.
  • This position leads all of the commercial and government contracting functions of the organization, and will be responsible for developing a portfolio contacting strategy that will support the net revenue growth objectives of the organization and other stakeholders.
  • In this capacity this individual will Lead the Company Joint Payer Contracting Committee which is comprised of representatives of the Company CIN, Hospitals, Home Health, Pharmacy, Behavior Health and other clinical areas as needed. As part of this role this executive will have direct input into the development of processes that engage stakeholders in the contracting process. S/he will be responsible for educating Committee Members and stakeholders and will build a consensus regarding key contracting decisions and strategies
  • Provide input to senior management and other enterprise-wide stakeholders relative to business development and strategic positioning as it relates to payer strategy
  • Serve as Company 's senior liaison to the payer community. Oversee and guide negotiations with third party payers on behalf of the enterprise to ensure the results meet enterprise goals. S/he will build strong relationships with insurance counter-parts that serve as a basis for collaboration, operational alignment, and financial structures that support the transformation of the care delivery to a population health orientation.
  • Pursue and develop relationships with payers and employers with regard to new payment models that support the strategic goals of the enterprise.
  • Monitor relevant policy at a state and national level and assess opportunities and threats related to emerging and evolving issues
  • With sound knowledge of organization 's mandate, priorities, and deadlines, direct a team to establish work schedules, process timelines and structure project milestones, to ensure execution of all aspects of contracting and related operations.
  • Operate effectively in a highly integrated, matrix environment where s/he will regularly consult with colleagues and recommend plans of actions on a broad range of strategic and tactical initiatives.
  • Applies current knowledge and understanding of regulations, industry trends, current best practices, new developments, and applicable laws to ensure operational and financial effectiveness. Partners to ensure regulatory compliance for all areas of responsibility Qualifications:
    • A Master 's Degree in Health Care, Public Health or Business Administration is required
    • 10+ years related experience in broad based analytical, managed care payor or provider environment; management or leadership experience; or
    • 10+ years related work experience in managed care; payer and provider experience desirable
    • Experience with and understanding of health care reimbursement methods, health care payment reform both locally and nationally,
    • Knowledge of the various stakeholders in the Massachusetts health care landscape desired
    • Experience working with cross-functional teams in complex organizations
    • Experience with or understanding of the population health, including clinical considerations
    • Experience hiring, training and managing teams and matrixed staff
    • An equivalent combination of education and experience, which provides proficiency in the areas of responsibility listed above, may be substituted for the above education and experience requirement.
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Keywords: ExecuNet, Boston , SVP of Payer Strategy Apply to This Job, Other , Burlington, Massachusetts

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