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Manager,Value Based Payment Initiatives

Eugene, Oregon Apply Now Job ID 1159438 Additional Locations US,Oregon;Tigard Category Leadership Organization Trillium Community Health Plan Schedule Full-time
Position Purpose: The Manager , Value Based Payment initiatives will drive the execution of the organizations Value Based Payment contracting strategies (VBP). This position will be responsible for working with the VBP AVP, VBP Analysts 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.

Work collaboratively with Contract Management to design and refine, the VBP contract negotiated with each assigned VBP Provider Group partnership. Accurately and effectively communicate the status of each VBP relationship to the VBP team and other internal cross-functional leads. Ensure that performance data is shared with VBP partners on a regular basis with particular emphasis on highlighting those areas in need of performance improvement. Appropriately prioritize and escalate VBP issues to the AVP of VBP Initiatives. Recommend reporting enhancements based on VBP partner feedback and needs identified through regular use of the existing reporting tools. -Work with each assigned 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. Drive 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. Drive building and maintaining relationships with key individuals at assigned PPS organization and their related VBP contracting entities. Drive the tactical execution of the business plan objectives to drive success of each VBP relationship. Act as a subject matter expert on all VBP related matters. Lead in implementation for VBP assigned relationships including third party vendors. Provide daily leadership 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.

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. Two to five years of relevant payroll managed care experience including at least one year of experience implementing/managing VBP programs or at least 18 months of experience working as a consultant focusing on the implementation of VBP arrangements with at least an additional two years of relevant experience. 
Educations/Experience described above. Communicate with technical and business constituencies effectively. Experience in writing business specifications and requirements.

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.
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