Professional, Network Strategy Program Manager
Professional, Network Strategy Program Manager
Responsible for supporting and facilitating network strategy by developing and supporting the adoption and implementation of new innovative Network programs aimed at reducing the total cost of care, improving population health and creating an enhanced member experience in order to drive growth. This individual will work in coordination with the Sr. Leader, Network Strategy to develop new, innovative program models that are aligned with and augment existing value-based programs promoted by MVP, New York State Department of Health (NYSDOH), and the Centers for Medicare & Medicaid Services (CMS), participating in business development initiatives, and building network intelligence capabilities.
The role focuses program development aimed at promoting priority network strategy initiatives and achieving targeted business and population health outcomes — clarifying strategic intentions; identifying desired business outcomes; incenting new care models, exploring implications, impacts and risks; promoting new programs and supporting outreach and adoption; coordinating inter-departmental efforts to address barriers to successful program implementation and partner success; and addressing stakeholder questions.
Works closely with leadership in Network Management and Health Management and across the organization to support the primary goal of design, implementation, and oversight new models as well as facilitate both strategy and innovation planning around the delivery of high-value, high-quality, cost-effective care.
Responsibilities to include:
- Defining new innovative programs including the development of new models, such as, but not limited to models for: FQHCs/Medicaid, Behavioral Health/Co-Attribution, Primary Care Capitation, Bundles and other Alternative Payment Models, etc.
- Surveilling the market, presenting data, and making recommendations to inform/support executive decision-making related to existing and new value-based models promoted by MVP, NYSDOH, and CMS to enhance member retention & growth,
- Promoting and supporting outreach and adoption of the new models with providers in conjunction with the Network Strategic Account Management Team, Network Management, Health Management, Informatics and Provider Relations as required.
- Participating in and supporting business development and sales support,
- Leveraging technology and information to enable the organization's future-state business capabilities, which can enable or alter business processes or practices that, in turn, drive the organizations targeted business outcomes,
- Work with Network Analytics and Informatics to develop program evaluation requirements for implemented programs,
- Representing MVP in internal and external meetings as a program subject matter expert, including multi-payer collaboratives, and providing feedback on innovation models as required,
- In addition to these primary responsibilities, will perform other duties as assigned in fulfillment of MVP’s broader Network Strategy goals.
The individual in this role leads deliverables that are valuable to the business, including program definition and business requirements, workflow and functional capabilities. Must be willing to travel and attend required meetings, business development opportunities and trainings. Performs other duties as assigned.
- Bachelor’s degree business, health policy, health care administration or related field.
- Equivalent amount of education and related experience considered.
- Master’s Degree preferred.
- At least five years of increasing responsibilities with health plan, provider, government/public agency or health care vendor experience.
- Minimum of two years’ experience developing and managing programs.
- Experience with provider outreach, adoption and business development support preferred.
- Prior analytical and reporting experience related to utilization, financial, efficiency and quality data in health care environment preferred.
- Experience working with multidiscipline, high-performance work teams.
- Exhibited skills in leading program development and management efforts involving the coordination of resources and goals across departments and multiple related projects.
- Candidates with strong analytics background coupled with policy, network management, healthcare product development/strategy experience preferred.
- Candidates with experience with value-based programs, New York State DSRIP initiatives, and/or CMS innovation programs preferred.
- Naturally inquisitive and a voracious learner. Must enjoy working on challenging, creative and innovative projects and initiatives.
- Ability to communicate, present, influence and persuade — both business and IT leaders as well as peers.
- Knowledge of existing, new and emerging methodologies in health care network/payment management (such as value-based payment approaches) and the ability to practically apply them to new business designs and business models.
- Strong analytical and conceptual skills; ability to create original concepts and theories for a variety of projects. Experience with Excel and other software solutions such as: Tableau, Power BI, etc. is desirable.
- Statistical and information analysis skills. Knowledge of ETGs and quality measures is desirable.
- Exhibited skills in leading program management efforts involving the coordination of resources and goals across multiple related projects.
- Experience developing and monitoring delivery of efficient and effective solutions to diverse and complex business problems.
- Ability to establish and maintain a high level of customer trust and confidence.
- Ability to analyze project needs and determine resources needed to meet objectives and solve problems that involve remote and elusive symptoms, often spanning multiple environments in a business area.
- Understand business process management, workflow and integration methods and tools.#ZIP
MVP Health Care is an Affirmative Action/Equal Opportunity Employer (PDF). We recruit, employ, train, compensate, and promote without regard to race, religion, creed, color, national origin, age, gender, sexual orientation, marital status, disability, genetic information, veteran status, or any other basis, e.g., Pay Transparency (PDF), protected by applicable federal, state or local law. Any person with a disability needing special accommodations to the application process, please contact Human Resources at email@example.com.
- Job Family Network Management & Development
- Pay Type Salary
- Headquarters Office, 625 State Street, Schenectady, New York, United States of America