Indianapolis, IN, United States
9 hours ago
Director of Contract Management, Payer Relations & Quality, IHCI

Join Community
The Innovative Healthcare Collaborative of Indiana (IHCI) is a joint venture between Community Health Network and Deaconess Health System. Its goal is to support our sponsors and partners in their strategic evolution to positively impact and improve the healthcare delivery system.

Make a Difference
The Director of Contract Management & Payer Relations, IHCI has primary responsibility for oversight of value-based care contract management and health system engagement. This role will lead IHCI strategic initiatives and select partner requested population health initiatives. The Director is responsible for but not limited to:

Oversee projects to optimize payer contract quality and bonus performance Understand and manage program and contract terms for managed populations Create and monitor dashboards to drive performance and report to stakeholders Ensure accuracy and compliance of ACO Participant and Preferred Provider lists Chair ACO Quality Committees and develop annual strategies Develop and communicate Value-Based Care/ACO strategy and CMS regulatory reporting Oversee provider and health system engagement activities and personnel Lead and mentor quality team members to foster a positive culture Drive quality and contract initiatives with provider partners, payers, and health systems Analyze and report performance data across various functions Design and implement interventions to meet contractual targets Leverage technology for process improvement and quality results Support innovative models for provider engagement and member experience Identify and document best practices for value-based arrangements

Exceptional Skills and Qualifications
Applicants for this role must possess a high degree of integrity and bring both the energy and initiative necessary to build out and scale operations associated with sustainable performance in value-based care. 

Bachelor’s degree in business or a health-related field is required Master’s degree in business, healthcare, or a related field is strongly preferred Seven (7) or more years of experience in healthcare and/or managed care operations Three (3) or more years of experience in a leadership role Seven (7) or more years of experience in leading Medicare ACOs, understanding value-based contracts, working with managed care products, leading population health operations, process improvement, and organizational effectiveness is preferred Threes (3) or more years of experience leading and managing operations across multiple markets Three (3) or more years of working knowledge of clinical quality metrics such as RAF, HEDIS, NCQA, or National Quality Forum-type metrics  Five (5) years of experience in data analytics comprehension  Five (5) years of Familiarity and understanding of CMS rules, regulations, and compliance requirements
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