Summary:
The Director, Payment Innovation has responsibility for supporting the company in Value-Based Care payment models. This position will work in a matrixed model with other departments such as Market Operations, Physician and Clinical Services, Managed Care, Strategy and Business Development, Legal, and Compliance . The Director will also be prepared to manage ongoing Medicare Bundled Payment initiatives and research new opportunities presented by the marketplace such as the expected CMS TEAM Model program expected to be implementation in 2026. The Director will be asked to engage in financial and operational discussions with company leadership with a high degree of professionalism. The Director will work to identify opportunities to improve performance to improve quality of patient care 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 Duties and Responsibilities include the following. Other duties may be assigned.
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Financial reporting and analysis – Prepare recommendations to market, hospital and physician leaders after thorough review and evaluation of reporting related to:
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Bundled Payment Models and concepts
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Accountable Care Organizations (ACOs)
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Other Population Health strategies
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Monitors 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.
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Assists department management by compiling and reviewing reports to present to senior management.
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Presents project status updates by defining progress, problems and solutions.
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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.
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Manages physician gainsharing programs and distributions in an accurate and timely manner.
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Maintains industry knowledge around payment reform models.
Qualifications:
To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
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Must be comfortable taking a leadership role in an integrated matrixed health care delivery system.
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Must demonstrate strong values, ethics and integrity.
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An anticipatory leadership style which is based on relationship building, influence, credibility, trust, education and respect.
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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.
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Possess strong organizational and analytical skills
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Highly developed written and verbal communication skills.
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Excellent project management and prioritization skills. Must have the ability to multi-task on varying projects and challenging initiatives with an entrepreneurial spirit.
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Must be able to collaborate in a team environment by contributing ideas as well as handling constructive criticism as opportunities for growth.
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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.
Reasoning Ability:
Ability to define problems, validate data, establish facts, and draw valid conclusions and with well supported recommendations is required.
Computer Skills:
To perform this job successfully, individual should have strong knowledge of Microsoft Excel, Work, and PowerPoint
Education/Experience:
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Masters prepared or equivalent in business, finance, healthcare or other related discipline with 5 years’ plus of related experience and/or training.
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Significant leadership experience with Bundled Payment, Clinically Integrated Network (CIN) and/or Accountable Care Organization (ACO) reimbursement models should prove very helpful in performing this role.
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Working knowledge of care delivery and reimbursement in multiple healthcare settings including, for example, ambulatory, acute hospitals, post-acute facilities and homecare
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Relevant experience and demonstrated success in change management, planning models and methodology, managing complex projects in a matrix organization, system collaboration and program implementation
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Demonstrated skills in the areas of supervision, management, written and verbal communication, judgment, problem solving and presentation
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Ability to read, write, interpret and counsel on technical or complex information
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Ability to model and assess the financial impact of changes to reimbursement models
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.
