Analyst, Value Based Payment Initiatives

You could be the one who changes everything for our 28 million members as a clinical professional on our Medical Management/Health Services team. Centene is a diversified, national organization offering competitive benefits including a fresh perspective on workplace flexibility.
 

Position Purpose: Analyst of Value Based Payment initiatives will assist in the execution of the organizations Value Based Payment contracting strategies (VBP). This position will be responsible for working with the VBP AVP, VBP Managers and other cross functional teams in the management of multiple VBP relationships including Provider Groups (IPAs) and the other contracting entities like ACOs and potentially DSRIP PPSs.

• Expand and improve Value-Based Payment contracting relationships by refining existing VBP models aimed at reducing avoidable costs and improving health outcomes, in alignment with the New York State Department of Health and Center for Medicare and Medicaid Services’ Value Based Payment programming. Support exploration of additional VBP models across the Fidelis product portfolio.
• Build relationships as the engagement analyst with contracted Provider Groups, Independent Physician Associations (IPAs), Accountable Care Organizations (ACOs), Hospital and Health Systems and other contracting entities in identifying opportunities in financial and quality performance to support VBP partners in value-based payment arrangements.
• Recommend reporting enhancements based on VBP partner feedback and needs identified through regular use of the existing reporting tools.
• Appropriately prioritize and escalate VBP issues to the AVP and Managers of VBP Initiatives.
• Work with the Manager / Lead of each VBP partner to develop strategies and action plans designed to eliminate any aberrant utilization and or quality of care patterns that will prevent the VBP partner from having a successful outcome through its Fidelis VBP relationship.
• Assist internal and external VBP meetings (clinical, IT, legal, etc ) in order to resolve any issues related to the operation of those VBP relationships that have been assigned.
• Assist in tactical execution of the business plan objectives to drive success of each VBP relationship.
• Assist in building and maintaining relationships with key individuals at assigned PPS organization and their related VBP contracting entities.
• Act as a subject matter expert on all VBP related matters.
• Assist in implementation for VBP assigned relationships including third party vendors.
• Provide daily assistance in the management of VBP activities, including data analysis, problem resolution and other activities to assist in the facilitation of a successful relationship with assigned Provider Group Partners.
• Performs other duties as assigned.
• Complies with all policies and standards.

The VBP Strategy:

• Is consistent with the New York State Roadmap For Medicaid Payment Reform (the Road Map).
• Incorporates incentives that encourage providers to improve the quality and effectiveness of the services they provide while simultaneously reducing their unnecessary use of delivery system resources.
• Does not disrupt the organization's preexisting relationships with any provider partners.
• Results in aggregate quality and financial outcomes that are consistent with the organization's objectives.

Education/Experience: BA/BS – Bachelors Degree Required. MBA/MHA/MPH Preferred. Graduate education in health care administration or other related areas preferred. Minimum of 1-3 years of relevant healthcare operation or policy experience. Communicate with technical and business constituencies effectively. Experience in writing business specifications and requirements. Knowledge of Financial, Asset Management, and Expense modules.

Pay Range: $55,100.00 - $99,000.00 per year

Centene offers a comprehensive benefits package including: competitive pay, health insurance, 401K and stock purchase plans, tuition reimbursement, paid time off plus holidays, and a flexible approach to work with remote, hybrid, field or office work schedules.  Actual pay will be adjusted based on an individual's skills, experience, education, and other job-related factors permitted by law, including full-time or part-time status.  Total compensation may also include additional forms of incentives. Benefits may be subject to program eligibility.

Centene is an equal opportunity employer that is committed to diversity, and values the ways in which we are different. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other characteristic protected by applicable law.

Qualified applicants with arrest or conviction records will be considered in accordance with the LA County Ordinance and the California Fair Chance Act