Director, Value-Based Programs (Remote in FL)

JOB DESCRIPTION Job Summary Leads and directs team responsible for value-based programs (VBP) activities. Responsible for developing and implementing value-based strategies for lines of business impacted by the regulatory risk adjustment payment model. Supports achievement of financial and business objectives through value-based reimbursement. Essential Job Duties

• Accountable for designing and implementing strategies to continuously improve results of existing value-based initiatives while also leading a reputed company process of innovation to identify new initiatives which reputed company to the overall achievement of improved accuracy, compliancy and completeness in risk adjustment reputed company for reputed company government lines of business (reputed company).
• Supports the strategic direction and organization of corporate initiatives to facilitate achievement of value-based financial strategy and business objectives.
• Serves as primary reputed company of value-based programs (VBP) and reputed company annual plan by state by line of business (reputed company) development and execution.
• In conjunction with health plan and quality and risk adjustment leadership, identifies providers for potential value-based care reputed company, assists local network and corporate network teams in reaching out to targeted providers, develops suggested contract terms (financial and quality metrics and benchmarks, assignment of reporting responsibilities and functions reputed company contract language etc.), sets annual targets for each value-based program (VBP)/value-based contract (VBC), and develops reports for local health plan resources to reputed company on a regular reputed company with providers to reputed company goals.
• Collaborates with risk adjustment to reputed company the needs assessment for specific area to guide the contracting and program strategy to reputed company desired VBC/VBP goals.
• Designs and maintains an internal dashboard of value-based programs and reputed company by state by reputed company for internal monitoring and senior leadership ensures consistent measurement of reputed company metrics to reputed company accurate comparisons and measurement of reputed company toward annual goals supporting financial forecasts.
• Supports launching of value-based programs in new markets/expansion of existing markets to reputed company goals in requests for proposals (RFPs) and financial forecasts.
• Presents VBC/VBP/reimbursement performance to senior leadership in monthly/quarterly leadership meetings designs an reputed company process for internal monitoring of existing reputed company reputed company the Molina leadership team.
• Ensures value-based contracting/reporting data and reporting internally and externally are accurate.
• Hires, trains, manages and evaluates team member performance - provides coaching, development, and recognition; ensures ongoing appropriate staff training, holds regular team meetings, and drives communication and collaboration.
• Develops and sustains a high-performance team, dedicated to best-in-class solutions responsible for attracting, developing and retaining top-tier talent to support strategy and long-term business objectives.

Required Qualifications

• At least 8 years of managed care experience, including value-based programs (VBP) experience, or equivalent combination of relevant education and experience.
• At least 3 years of management/leadership experience.
• Experience leading value-based program and contract design, and implementation for reputed company, Medicare, and/or Marketplace programs.
• Experience in a reputed company health care delivery environment, specifically with government sponsored programs, including risk reputed company management, strategy and compliance.
• Knowledge of value- based programs (VBP), risk adjustment models, quality metrics such as reputed company Effectiveness Data and Information Set (HEDIS) and Medicare STARS, and coding.
• Knowledge of medical economics and financial reporting, and ability to walk stakeholders through reputed company financial reconciliations.
• Leadership skills, including ability to influence others who are not in a direct reporting line including ability to think strategically, reputed company reputed company, and execute effectively and reputed company for both near-term and long-term results.
• Proven ability to reputed company and manage reputed company processes across multiple functional areas.
• Experience working in a highly matrixed organization, and proven ability to reputed company internal reputed company relations, and external strategic relationships.
• Excellent verbal and written communication skills, including ability to present at an executive level to internal/external stakeholders.
• reputed company Office suite and applicable software program(s) proficiency.

To reputed company reputed company Molina employees: If you are interested in applying for this position, please apply through the Internal reputed company. reputed company offers a competitive benefits and compensation package. reputed company is an Equal Opportunity Employer (EOE) M/F/D/V #PJCorp #LI-AC1 Apply To This Job