Job Summary:

The Director, Enterprise Value Based Reimbursement (VBR) Strategy serves as the enterprise-wide VBR strategy lead to all markets and lines of business. The Director will lead ongoing engagements with market leadership to build VBR strategy plans, collaborate with state partners around VBR strategy, and coordinate VBR program solutions for markets.

Essential Functions:

• Support the development and execution of both enterprise-level and market-specific value-based reimbursement (VBR) strategies to enhance organizational alignment and effectiveness across various markets and lines of business.
• Collaborative with market leadership on VBR strategies that address specific requirements for Request for Proposals (RFPs), and continue collaboration post-RFP to build and implement effective VBR program plans.
• Partner closely with market leadership to ensure compliance with state-level VBR requirements and commitments by leveraging appropriate strategies and programs to meet regulatory expectations.
• Build strong, influential, and collaborative relationships with key internal stakeholders and external partners to shape and drive VBR program strategy.
• Lead discussions with healthcare providers and organizations that are instrumental in fostering enterprise-wide VBR partnerships.
• Continuously evaluate and adjust VBR programs to ensure they remain in alignment with enterprise objectives, enhancing their impact and relevance.
• Oversee the development and operationalization of policies, standards, benchmarks, performance metrics, and quality control mechanisms to ensure high standards in VBR strategy execution.
• Maintain up-to-date knowledge of regulatory changes and market-specific performance standards to guarantee compliance and ensure timely execution.
• Lead negotiations and contract discussions with healthcare providers identified as providing innovative care solutions that support a comprehensive national VBR approach.
• Provide leadership, mentorship, and professional development opportunities to staff, fostering a supportive environment that encourages growth and excellence in performance.
• Perform any other job related duties as requested.

Education and Experience:

• Bachelor's degree in management, healthcare management or related field is required
• Master's degree is preferred
• Equivalent years of relevant work experience may be accepted in lieu of required education
• Five (5) years of experience in value-based reimbursement design, methodologies and/or VBR contracting, data analysis, reporting, or data support is required
• Three (3) years of Provider contracting or Provider relations is required
• Five (5) years of leadership/management experience is required

Competencies, Knowledge and Skills:

• Proficient in Microsoft Office to include Word, PowerPoint, Access - advanced proficiency in Excel
• Excellent team facilitation skills
• High level of analytic skills for solving problems
• Excellent oral, written, and interpersonal communication skills
• Strong knowledge of Value Based Contracting methodologies and operations and/or experience in health care quality
• Knowledge of provider contracting and familiarity with provider network operations
• Critical listening and thinking skills
• Problem solving skills
• Attention to detail and work plan creation, implementation, and evaluation
• Business acumen and strategic thinking skills, yet able to execute tactically
• Strong relationship management skills and ability to maintain and build strong working relationships in a matrix environment

Licensure and Certification:

Working Conditions:

• General office environment; may be required to sit or stand for extended periods of time
• Up to 15% (Occasional) travel to attend meetings, trainings, and conferences may be required

Compensation Range:

$110,800.00 - $193,800.00

CareSource takes into consideration a combination of a candidate’s education, training, and experience as well as the position’s scope and complexity, the discretion and latitude required for the role, and other external and internal data when establishing a salary level. In addition to base compensation, you may qualify for a bonus tied to company and individual performance. We are highly invested in every employee’s total well-being and offer a substantial and comprehensive total rewards package.

Compensation Type (hourly/salary):

Salary

Organization Level Competencies

• Fostering a Collaborative Workplace Culture

• Cultivate Partnerships

• Develop Self and Others

• Drive Execution

• Influence Others

• Pursue Personal Excellence

• Understand the Business

This job description is not all inclusive. CareSource reserves the right to amend this job description at any time. CareSource is an Equal Opportunity Employer. We are dedicated to fostering an environment of belonging that welcomes and supports individuals of all backgrounds.

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