Easter Seals Jobs

Summary:

The Senior Director of Payment Innovations manages several projects supporting various alternative payment models to help CHS leaders plan for and understand their potential impact on CHS hospital and clinical operations.

Essential Duties and Responsibilities include the following. Other duties may be assigned.

• Provides general support of payer-driven and value-based quality programs. This includes but is not limited to Medicare Traditional and Advantage, Commercial, governmental, ACO, BPCI, CJR, and other quality-related and value-based reimbursement programs.

• Assists in verifying the CMS reconciliation data and NPRA (Net Payment Reconciliation Amount) results for the Bundled Payment programs.

• Analyze standard metrics and reports to support ACO/BPCI and other program operational efforts. Assists department management by compiling and reviewing reports to present to senior management.

• Maintenance and management of key data tables as they relate to program participants. Oversees yearly processes to make adjustments to participants, contracts, or other facets of payer models in use.

• Supports the effort in identifying areas of improvement, assists in the development of tactical plans in conjunction with the Payment Innovations team and other business partners to address gaps, and monitor success of those plans.

• Prepares and presents periodic and ad hoc reports and educational material in a wide variety of settings.

• Supports with special projects as requested. Presents project status updates by defining progress, problems and solutions.

• Attends professional development educational events relevant to the scope of payer programs to ensure full understanding of payer and reimbursement trends, regulatory changes, and national initiatives related to quality and value-based payment programs. Maintains industry knowledge around payment reform models.

• Assist in development of educational and training materials for field operators as it relates to value-based care.

• Audits and reviews reporting dashboards for data quality/integrity using various analytical tools as appropriate.

• Assists with the submission and coordination of applications and other documents for both ACO and other Value-Based Care (VBC) Programs.

• Provides financial accounting for all VBC programs and ensures timely payment of all distributions and invoices

• Works with Internal Audit and Legal to ensure distribution calculations and amounts are consistent with existing programmatic distribution models

• Perform all other duties as assigned.

Qualifications:

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

• Possess strong knowledge of Microsoft Excel and PowerPoint.

• Possess strong organizational, written and verbal communication skills.

• Possess an understand of GAAP based account principles

• Data analysis experience to interpret patterns, trends, and outcomes as it relates to healthcare data.

• Excellent project management and prioritization skills. Must have the ability to multi-task on varying projects and challenging initiatives with an entrepreneurial spirit.

• Must be a self-starter and be able to perform research independently. Must be able to work independently within stated goals and objectives and have the commitment to achieve those goals and objectives within the given time constraints.

• Must be able to collaborate in a team environment by contributing ideas as well as handing constructive criticism as opportunities for growth.

• Ability to maintain a flexible schedule as needed for special projects.

• May travel on occasion as needed based on the project requirements

• Ability to maintain confidentiality and exercise high level of integrity and trust.

Reasoning Ability:

Ability to define problems, collect data, establish facts, and draw valid conclusions. Ability to interpret an extensive variety of technical instructions in mathematical or diagram form and deal with several abstract and concrete variables. Must be a self-starter and be able to perform research independently.

Computer Skills:

To perform this job successfully, an individual should have a familiar working knowledge of Microsoft Office (Word, Excel, PowerPoint), and email applications.

Physical Demands:

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

Certificates and Licenses:

Preferred: N/A

Supervisory Responsibilities:

Responsible for supervising a team and ensuring the process and delivery of key performance indicators as defined

Education/Experience:

Preferred: Master’s Degree in Business, Finance, or Accounting. Background in healthcare, project management, data analysis, finance, and/or business. Experience with Alternative Payment Models desired.

Required: Bachelor’s Degree from accredited school/university. Minimum 5 years of leadership experience, 2 years of experience in VBC arrangements preferred.

Equal Employment Opportunity

This organization does not discriminate in any way to deprive any person of employment opportunities or otherwise adversely affect the status of any employee because of race, color, religion, sex, sexual orientation, genetic information, gender identity, national origin, age, disability, citizenship, veteran status, or military or uniformed services, in accordance with all applicable governmental laws and regulations. In addition, the facility complies with all applicable federal, state and local laws governing nondiscrimination in employment. This applies to all terms and conditions of employment including, but not limited to: hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absence, compensation and training. If you are an applicant with a mental or physical disability who needs a reasonable accommodation for any part of the application or hiring process, contact the director of Human Resources at the facility to which you are seeking employment; Simply go to http://www.chs.net/serving-communities/locations/ to obtain the main telephone number of the facility and ask for Human Resources.