Staff Vp Payment Modeling and Analytic Reporting

Profile

Staff VP Payment Modeling and Analytic Reporting
The candidate leads the analytic strategy and financial operations execution for Elevance Health’s VBC programs across all lines of business. This includes total cost contracts, bundled payments, and other specialty care programs. Establishes financial management governance, and operational readiness plans, for program administration - including development of attribution model(s), definition of performance metrics, development of financial and quality targets, calculating monthly reconciliations and financial accruals, administering provider payments and designing reports/insights.  Responsible for overseeing all of Elevance Health’s VBC financial reconciliations, representing over $60B at risk. Accountable for multiple analytic products, including Enterprise VBC administration platform, and responsible for requirements, testing and lights on maintenance.  Collaborates with senior leadership from Information Technology/Digital, Healthcare Networks, and Value Based Solutions business partners to ensure products deliver value and align/enable other related capabilities. Oversees payment readiness and advisory functions for Elevance Health’s value-based programs. Develops opportunity reporting, monitors key program financial metrics, identifies drivers of metric fluctuations and provides consultative services to Healthcare Networks local markets. Ensures provider payments are issued accurately and timely. Represents the Vice President of Health Economics at symposiums and key meetings with regulators, provider groups, customers, and internal business areas. Hires, trains, coaches, counsels, and evaluates the performance of direct reports. Requires a BA/BS in a related field and 10 years of progressive experience in managed care or integrated health services with an understanding of reimbursement methods including Fee For Service (FFS), Pay for Performance (P4P), bundles, capitation, and global budgets; minimum of 8 years of direct management experience of healthcare analytics teams, or any combination of education and experience, which would provide an equivalent background. MBA, JD or MHA is strongly preferred. JOC experience is preferred. Strong leadership experience managing people and collaborating across matrixed organizations.

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