Highmark Health Value-Based Reimbursement Strategic Partners Consultant - Remote Role
This job works closely with management, assisting in developing new reimbursement models for the Organization's strategic partners and initiatives. The incumbent influences VBR integration into the overall Enterprise strategy through collaboration with Senior-level internal/external stakeholders. Ensures a high degree of development, efficiency, and effectiveness on the support and deployment of all VBR Design models.
ESSENTIAL RESPONSIBILITIES
Support and lead, as needed, the development and completion of sales cycle (from model conception to implementation) of VBR programs for key strategic accounts and/or initiatives.Support strategic provider relationships to understand the current health care delivery state, readiness for change, test value-based programming concepts and components, identify key partners, and proactively communicate market transformation concepts with providers and professional advocacy societies and key thought leaders.Ensure integration with Enterprise/PNR strategic direction. Collaborate with PNR stakeholders to incorporate VBR into product, network, and provider integration.Liaison with Enterprise & P&L leaders on their overarching strategies to ensure broader alignment of VBR approach.Develop targeted reimbursement models that support enterprise strategic initiatives that might fall outside of planned value-based reimbursement designs and/or to serve as a focus of innovation.Build collaborative relationships within the organization and with external local, regional, and national healthcare industry leadership to inform market transformation strategies and to advance the organization's vision for care delivery transformation.Support the development of the overall conceptualization, strategy alignment, and high-level design of new value-based reimbursement models for PCPs, specialists, and health systems across the Organization's footprint.Work with reimbursement, actuary, and analytic departments to ensure that operational capabilities are built in line with the strategic roadmap to ensure maximum flexibility and speed to market.Serve as a subject matter expert working in concert with provider relations and clinical transformation consultants to explain new programs and results to key provider partners.Collaborate with and support the senior Strategic Partners Consultant role as needed.Other duties as assigned or requested.EDUCATION
Required
- Bachelor's Degree in Public Health, Health Administration, Economics, Mathematics, Engineering, Marketing, Business Communications or related field
Substitutions
- 6 years of related and progressive experience in lieu of Bachelor's degree
Preferred
- Master's Degree in Public Health, Health Administration, Economics, Mathematics, Engineering, Marketing, Business Communications or related field
EXPERIENCE
Required
- 5 years in the Health Insurance industry, Healthcare industry, and relationship management
Preferred
- 5 years of Consulting
- 1 year in a Provider facing role
- 1 year with Provider payment/reimbursement
- 1 year with strategic planning/corporate development
LICENSES AND CERTIFICATIONS
Required
Preferred
SKILLS
- Analysis of business problems/needs
- Consulting
- Problem Solving & Decision Making
- Project Management
- Strategic Partnerships
- Strategic Relationship Building
- Strategic Thinking
Language (Other than English)
None
Travel Required
0% - 25%
PHYSICAL, MENTAL DEMANDS and WORKING CONDITIONS
Position Type
Office-based
Teaches / trains others regularly
Occasionally
Travel regularly from the office to various work sites or from site-to-site
Rarely
Physical work site required
Yes
Lifting: up to 10 pounds
Constantly
Lifting: 10 to 25 pounds
Occasionally
Disclaimer: The job description has been designed to indicate the general nature and essential duties and responsibilities of work performed by employees within this job title. It may not contain a comprehensive inventory of all duties, responsibilities, and qualifications required of employees to do this job.
Compliance Requirement : This job adheres to the ethical and legal standards and behavioral expectations as set forth in the code of business conduct and company policies.
Pay Range Minimum:
$67,500.00
Pay Range Maximum:
$124,800.00
Highmark Health and its affiliates prohibit discrimination against qualified individuals based on their status as protected veterans or individuals with disabilities, and prohibit discrimination against all individuals based on their race, color, age, religion, sex, national origin, sexual orientation/gender identity or any other category protected by applicable federal, state or local law.
EEO is The Law
Equal Opportunity Employer Minorities/Women/Protected Veterans/Disabled/Sexual Orientation/Gender Identity
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