Informs strategic development, value analysis, and contract management throughout the deployment of existing and new risk-based and value-based agreements (VBA), insurance products and VBA management initiatives. Emphasis will be on the product assessment, development, and marketing of Memorial Choice for larger, self-funded employers. In addition, this role will assist strategic and operational leaders in the assessment and development of existing and new products and lines of business as they relate to small-group, large-group, self-funded, individual, Medicaid and Medicare Advantage markets. Coordinates and assists with analysis around the regulatory, contractual, financial and quality domains of VBAs and VBA operations. Develop action items for improvement and recommendations. Work to further the strategic objectives of the organization, specifically as it pertains to payer strategies and the development and integration of strong provider networks and insurance partners. Specific outcomes this position will assist in achieving include; growing captured lives through value-based arrangements, ensuring product performance, creating standardized mechanisms by which to assess and report performance of VBAs, and achieving efficiencies in care provision and demand management within VBAs. Assist in ensuring all actions and organizational approaches meet legal, regulatory and ethical guidelines and will support the Managed Care Team in executing VBAs. Seeks out opportunities to inform and influence positive change that furthers the Memorial Health strategic objectives, mission, and vision, as guided by the values of the organization. 

Education:

• Bachelor’s degree, preferably in business or health care administration required

Master’s degree (MHA, MPH, MBA or similar) Preferred

Licensure/Certification/Registry:

Experience:

• Five (5) years of relevant experience working in healthcare, , and/or project management required.

Other Knowledge/Skills/Abilities:

• Excellent communication skills.
• Excellent analytical skills, with emphasis on both qualitative and quantitative contract analysis, financial analysis, and value analysis.
• Able to work independently and/or with multiple team members across various areas of MH and maintain positive working relationships.
• Ability to solve problems creatively. 
• Ability to plan, organize, administer, coordinate, and control multiple projects.
• Intermediate understanding of applicable rules, regulations, and legal statues impacting the health insurance and health care sector. Ability to interpret for leadership and explain the impact on operations and strategy.
• Knowledge of value-based arrangements and contracting, the legal/regulatory environment, and finances under value- and risk-based arrangements.
• Excellent PC skills, including the use of Microsoft Office products.

·       Ability to work in a fast-paced, changing, and ambiguous environment, and to understand industry trends and develop innovative solutions to meet or exceed industry and customer expectations.