AMVETS Jobs

Job Summary

The Director of Payment Innovations is primarily responsible for supporting the VP in assisting approximately 5 to 8 Accountable Care Organizations (ACOs) in their pursuit of physician engagement to achieve successful ACO and Value-based healthcare performance with the specific goal of enhancing hospital performance. Responsibilities include working with staff analysts to identify opportunities to improve performance through increased in-network utilization and use of preferred providers to improve quality of patient care, increase CHS Hospital readmission retention, reduce 30-day readmission penalties, and reduce unnecessary post-acute care utilization. The Director will be able to consider financial and quality of care metrics to identify and implement potential improvement opportunities.

Essential Functions

• Financial reporting and analysis - Prepare recommendations to market, hospital and physician leaders after thorough review and evaluation of reporting related to:

• Bundled Payment Models and concepts (BPCI, CJR and BPCI Advanced)

• Accountable Care Organizations (ACOs)

• Patient engagement and retention initiatives

• Other Population Health strategies

• Monitor performance of month/quarter/year-end key performance indicators by gathering accurate data through a variety of data sources. Identify opportunities to improve performance to ensure year-end goals can be achieved.

• Assess the financial impact, on a prospective and retrospective basis, of changes in payment models and communicates alternatives and recommendations.

• Assist department management by compiling and reviewing reports to present to senior management.

• Present project status updates by defining progress, problems and solutions.

• Evaluate and identify gaps in internal capabilities and processes for responding to payment model changes and makes recommendations to the Company regarding making, buying or partnering capabilities. This will require the person to coordinate with resources at corporate and local hospitals to formulate an understanding of current processes and changes needed to be responsive to changing payment models.

• Manage physician gainsharing programs and distributions in an accurate and timely manner.

• Maintain industry knowledge around payment reform models.

• Performs other duties as assigned.

• Complies with all policies and standards.

Qualifications

• Bachelor's Degree in business, finance, healthcare or other related discipline with 5 years’ plus of related experience and/or training required

• Master's Degree or equivalent in business, finance, healthcare or other related discipline with 5 years’ plus of related experience and/or training preferred

• 5-7 years significant leadership experience with Bundled Payment, Clinically Integrated Network (CIN) and Accountable Care Organization (ACO) reimbursement models should prove very helpful in performing this role required

• 5-7 years relevant experience and demonstrated success in change management, planning models and methodology, managing complex projects in a matrix organization, system collaboration and program implementation required

Knowledge, Skills and Abilities

• Must be comfortable taking a leadership role in an integrated matrixed health care delivery system.

• Must demonstrate strong values, ethics and integrity.

• A multi-dimensional thinker with the capacity to communicate, think, plan and act without being locked into a traditional model of health care delivery; the orientation to analyze complex situations and relationships and work with CHS leadership.

• Excellent project management and prioritization skills. Must have the ability to multi-task on varying projects and challenging initiatives with an entrepreneurial spirit.

• Must be able to collaborate in a team environment by contributing ideas as well as handling constructive criticism as opportunities for growth.

• Must be able to work independently within stated goals and objectives and have the commitment to achieve those goals and objectives within the given time constraints.

• Ability to define problems, validate data, establish facts, and draw valid conclusions and with well supported recommendations is required.

• Strong knowledge of Microsoft Excel, PowerPoint and Access.

• Working knowledge of care delivery and reimbursement in multiple healthcare settings including, for example, ambulatory, acute hospitals, post-acute facilities and homecare.

• Ability to read, write, interpret and counsel on technical or complex information.

• Ability to model and assess the financial impact of changes to reimbursement models.

Licenses and Certifications

• Certified Public Accountant (CPA) preferred

Equal Employment Opportunity

This organization does not discriminate in any way to deprive any person of employment opportunities or otherwise adversely affect the status of any employee because of race, color, religion, sex, sexual orientation, genetic information, gender identity, national origin, age, disability, citizenship, veteran status, or military or uniformed services, in accordance with all applicable governmental laws and regulations. In addition, the facility complies with all applicable federal, state and local laws governing nondiscrimination in employment. This applies to all terms and conditions of employment including, but not limited to: hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absence, compensation and training. If you are an applicant with a mental or physical disability who needs a reasonable accommodation for any part of the application or hiring process, contact the director of Human Resources at the facility to which you are seeking employment; Simply go to http://www.chs.net/serving-communities/locations/ to obtain the main telephone number of the facility and ask for Human Resources.