Summary

Partners with the SVP/CFO, Chief Physician Executive, Chief Clinical Integration Officer and Enterprise Transformation Committee on development and implementation of organizational strategies to achieve the System’s payer/population health strategic goals. Partners with the Chief Clinical Integration Officer on understanding and leading the organization to adapt to a changing health care environment, including government and other payer reforms, migration to value-based contracts and reimbursement methodologies, creative payer/provider relationships, development of new models of care to achieve quadruple aim objectives and leveraging both FFS and value-based contracts to maximize reimbursement. Ensures the System has the right business structure, tools, resources and capabilities and facilitates alignment and integration of key stakeholders including Parkview Care Partners, Parkview Value Plus, Parkview Physicians Group, Business Intelligence, Payer Contracting etc.to perform well under value-based contracts. Completes 360 reviews of all value-based contracts and making recommendations to improve performance. Partners with Business Intelligence on the development of robust financial/clinical analytics and predictive modeling. Leads the development and implementation of a Direct to Employer strategy to facilitate the System’s growth strategies (volume/attributed lives). Co-leads the Parkview Employee Health Plan Steering Committee. Partnering with the Chief Human Resources Officer and Chief Clinical Integration Officer on understanding and leading the Committee to design a health plan that best meets the following objectives: market competitive to recruit and retain values aligned talent; improves the health of the population served; engages members in their personalized health journey; reduces or bends the cost trend and allows Parkview to be a leader in the transformation to value. Plans, directs and coordinates the work of Payer Contracting and Employer/Health Plan Services. Ensures alignment of departmental goals with organizational objectives, implementation of best practice process and procedures that are compliant with regulatory or contract standards, development of performance metrics and targets, and implementation of performance improvement initiatives to ensure performance targets are achieved. Collaborates with all lines of business, executives, and direct reports to operationalize new strategies. Develops effective payer relationships. Develops and leads a highly effective team that assures contracts meet legal and operational standards as developed by the organization.

Education

Bachelor’s degree in a health related field, finance, or management required. Master’s degree preferred.

Experience

Must have 5-7 years of progressive experience in payer contracting in an integrated healthcare delivery system or equivalent payer experience with significant strategic health system experience.

Other Qualifications

Must demonstrate ability to build and maintain relationships, drive performance, and assure success at Parkview Health. Proven ability to lead both in a direction that fulfills the mission and goals of Parkview Health, as well as the ability to plan, implement and evaluate change. Excellent written and verbal communication skills.