CHS Corporate

VP Payment Innovations & Value-Based Care

Franklin

,

TN

Full Time

JOB SUMMARY

The VP of Payment Innovations & Value Based Care is responsible for providing strategic leadership in the development, implementation, evaluation, and optimization of value-based care programs. They will build and maintain an environment that attracts and retains employees committed to continuous quality improvement, innovation, creative problem solving, patient experience and employee engagement; and applies lean principles to achieve cost efficiencies in services provided.

This role focuses on enhancing patient outcomes, improving care coordination, and achieving financial performance goals. They will oversee operations related to the organization's participation in value-based care models and collaborate with market leadership, clinical teams and external partners to ensure alignment with organizational goals and the successful execution of value-based care strategies.

Key Responsibility:
  • Provide oversight and management of the organization's participation in Accountable Care Organizations, Value Based Care Initiatives, Clinically Integrated Care models, alternative payment models, and risk-based arrangements.
  • Develop and lead the overall strategy for value-based care initiatives including contracting and performance monitoring to ensure maximum capture of Value Based Care incentives
  • Monitor changes in payer quality requirements that impact reimbursement and monitor trends and best practices in value-based care and patient care delivery.
  • Collaborate with the CHS Managed Care department to engage and negotiate with payers, health plans, and other stakeholders to ensure appropriate contract terms and optimize performance within value-based care models.
  • Work collaboratively with corporate and local market operation, clinical and quality team members on quality improvement and value-based care initiatives.
  • Build and strengthen relationships with participating healthcare providers to enhance care coordination and improve patient care quality.
  • Leverage data to identify operational gaps and opportunities for improvement in care delivery, cost efficiency and patient outcomes.
  • Analyze financial data to ensure value-based care initiatives achieve financial performance targets.
  • Management
  • Ensure compliance with governmental and organizational policies
Qualifications
  • Bachelor's Degree Business, Finance, Nursing or similar required
  • Master's Degree MBA, MHA, MPA or similar required
  • 5-7 years implementing, monitoring and managing Value-based care programs from CMS and commercial/MA payers. Including ACOs, Bundled Payments, and Clinically Integrated Networks.
  • Recruiting and managing high functioning teams required
  • 7-9 years Management experience required
Knowledge, Skills and Abilities
  • Must have a deep knowledge in the management/knowledge of government (CMS/CMMI) innovations models. Strong acumen in VBC program management and implementation, along with a deep understanding of the rules and regulations governing those programs. Must be proficient in MS office and analytic platforms.
Reporting Structure

The position will have a dual reporting relationship with the MD VP for PPS and the VP of Managed Care