Leader, Regional VBP Account Management
Status: Full-time, Exempt: Yes
Leader, Regional VBP Account
Responsible for Provider Partner business development, strategic account management, negotiating VBP and alternate payment model contracts in the region and implementing strategic account plans for key provider relationships representing a significant proportion of MVP’s membership and clinical expenditures. Works with Network leadership, team members, key leaders/contributors across the organization, as well as key leaders/contributors from outside MVP to develop, negotiate, implement, oversee and evaluate value-based contract models and alternate payment models for the region, including: Shared Savings and Risk Models, Capitation, Global Payments, Bundles, Incentive Plans and
other non FFS reimbursement models. Develop an understanding of the needs and
goals of our participating providers as they transition into VBP, including social
determinants of health and Integrated Behavioral Health models, and support as
they successfully take on increasing levels of risk. The role involves coordinating senior level interdisciplinary
teams within MVP to solve complicated problems related to targeted
interventions designed to achieve the Triple Aim in collaboration with our
provider partners. Represents MVP on
regional collaboratives and leads internal and external meetings with senior
leaders, business partners for the development and management of long-term Provider
Relationships and VBP Arrangements. The
position is expected to be an active participant in Payment Reform activities
and to support the design, implementation and program management and evaluation
of the value-based contracts and programs in the region. Produces strategic
account plans to support provider engagement, as well as program
implementation, monitoring and evaluation. Ensures the establishment and
tracking of contracting and financial and quality settlements, as well as coordinates
other key milestones and deliverables. Oversees the provision and analysis of
scheduled, as well as ad hoc, data requests, information and reports. Supports
the response to VBP, Advanced Primary Care, regulatory or government surveys as
needed. The Leader is responsible for hiring, supervision and training of Population
Health Manager. In addition to these primary responsibilities, the Leader will
perform other duties as assigned in fulfillment of MVP’s broader VBP and Network
BA/BS in business, health care administration or related field preferred.
Equivalent amount of education and related experience considered.
Five years of health plan or provider experience
Five years of increasing responsibilities in working with providers and provider
organizations Minimum of two years’ provider contracting and negotiating experience
Two years’ experience managing team members and programs.
Minimum of three years of increasing experience in the Value Based Care programs or Population Health, including direct contracting experience
Experience with social determinants of health and community-based organizations is a plus, as is experience with Integrated Behavioral Health models.
Detail-oriented worker with excellent organizational skills, able to work on multiple projects simultaneously and meet deadlines.
Strong presentation, written and public speaking skills
Excellent leadership and training skills
Contracting and negotiating experience
Business development and strategic account management
Strong financial background, ability to analyze financial data required
Ability to effectively evaluate health care data
Strength in problem solving based on experience, subject matter expertise, and objective data analysis
Ability to effectively use Microsoft Office software
(Excel, PowerPoint, Microsoft Project, Access, Visio and Word).
Ability to travel as needed required
Knowledge of clinical workflows and/or clinical experience is a plus but not required
Knowledge of administrative datasets (i.e. claims, eligibility etc.) reporting /analytic
uses (e.g. cost and utilization reporting, disease management, quality measurement
etc.) and terminology (e.g. PMPM, and per 1000 measures, HEDIS and NQF quality
measurement, diagnosis/procedure codes, episode groupers, risk adjustment,
Project Management experience #ZIP
MVP Health Care is an Affirmative Action/Equal Opportunity Employer (PDF). We recruit, employ, train, compensate, and promote without regard to race, religion, creed, color, national origin, age, gender, sexual orientation, marital status, disability, genetic information, veteran status, or any other basis, e.g., Pay Transparency (PDF), protected by applicable federal, state or local law. Any person with a disability needing special accommodations to the application process, please contact Human Resources at firstname.lastname@example.org.
- Job Family Network Management & Development
- Pay Type Salary
- Tarrytown Office, 303 South Broadway, Tarrytown, New York, United States of America