Note: Interested candidates need to contact Katy Velten at firstname.lastname@example.org or apply directly at http://www.healthcaresource.com/bronson_i/index.cfm?fuseaction=search.jobDetails&template=dsp_job_details.cfm&cJobId=105701&fwkMethod=L&fwkKey=2005_4548_0_0_161108132156_1478629316266_4180#sthash.osGDKccT.dpbs
The position reports directly to the President and Chief Executive Officer of Affirmant Health Partners--a clinically integrated network of health systems including Bronson Healthcare, Covenant HealthCare, Henry Ford Allegiance Health, Henry Ford Health System, Lakeland Health, MidMichigan Health, Sparrow Health System and Spectrum Health.
· Works with the Affirmant Health Partners Contracting Committee and functional leadership to develop the network's contracting strategy, particularly as it relates to customer and product priorities.
· Engages and creates relationships with health plans, local brokers, employer health coalitions, and other community organizations; and directs, conducts, and supervises negotiations with insurance companies, HMOs, employers and other healthcare purchasers.
· Ensures the completion of modeling of changes in terms, rates, performance or other market dynamics to inform the negotiation strategy and ensures proper communication is maintained to all stakeholders on contracting issues.
· Works with the Affirmant Health Partners' and members' staff to understand the networks total cost of care, utilization, quality, access, and experience performance to support negotiations, relationship-building and performance improvement.
· Reviews and analyzes all shared savings, withhold payments, risk pool settlements & other post-adjudicated payments made by health plans and submits discrepancy reports within the required time limits.
· Manages Affirmant Health Partners' internal funds distributions to its Local Chapters, including the ongoing refinement of any risk allocation methodologies.
· Maintains knowledge of and reports changes in legislative and regulatory rules regarding managed care contracting, including both fee-for-service and value-based care. One or more days per week of travel--mostly day trips within the state of Michigan--is required.
· Master's Degree in Hospital, Healthcare or Business Administration and at least seven (7) years of experience in a senior contracting position on behalf of a large group practice, integrated health system, clinically integrated network, accountable care organization or managed care organization.
· Experience in risk or value-based contracting is required and familiarity with health plan operations and/or employer contracting is preferred.
· Demonstrated success with project management, leadership, negotiations and implementation.
Mental & Visual Fatigue: Work which produces very high levels of mental/visual fatigue, e.g., CRT work between 70 and 90 percent of the time and work involving extremely close tolerances and considerable hand/eye coordination for sustained periods of time.
Physical Effort: The job produces some physical demands, typical of jobs that include regular walking, standing, stooping, bending, driving, air travel, sitting and some lifting of light weight objects.