• Division VP Payer Strategy

    Requisition ID
    Employment Type
    Full Time
    Managed Care Contracting
    Hours Per Pay Period
    Corporate Office - KERP
    Posting Location : City
    Posting Location : State/Province
    Standard Hours ex: Monday - Friday (8:00 AM - 5:00 PM)
    Monday - Friday (8:00 AM - 5:00 PM)
    Work Schedule
    8 Hour
  • Overview

    Two legacies of caring. 
    One ministry of change. 

    CommonSpirit was created by the alignment of Catholic Health Initiatives and Dignity Health as a single ministry in early 2019.  More than 150,000 physicians, nurses, caregivers, and other staff are employed by CommonSpirit  Our hospitals and care centers cover 21 states.  CommonSpirit has the size and ability to scale best-in-class clinical service lines; recruit and retain top talent; standardize operations to improve quality and reduce the cost of care; and advocate more effectively for all people, especially those who are poor and vulnerable. For more information, please visit our website at www.commonspirithealth.org. You can also follow us on Twitter and Facebook.


    Position Summary:


    The Vice President, Division Payer Strategy and Relationships is responsible for providing strategic leadership and direction for all Payer Strategy and Relationship related activities, including but not limited to: developing and implementing Division payer strategy; building payer relationships; negotiating payer contracts; driving strategic market share growth; optimizing reimbursement rates and contract language; recruiting, leading, and developing personnel; performing financial analysis; and other payer strategy and relationship related activities for specific Divisions. The Vice President role will create and maintain successful relationships with customer stakeholders - including third party insurers, physician organizations, employers, government sponsors and other key partners.  Accountabilities include designing and achieving local payer strategy objectives, maintaining effective operational linkages to Strategy, Operations & Finance executives, Revenue Cycle Management, linking to National PSR strategic payer and product initiatives, and partnering with physician organization leaders in designing, contracting, and marketing IDNs and services. The Vice President is a key member of the PSR and Division senior leadership team.


    Core Duties:

    • Participates as member of the Division(s) senior leadership team and member of the Payer Strategy and Relationships (PSR) Leadership Team
    • Manages the Division(s) PSR team
    • Responsible for Division payer strategy and relationships and contracts with new and existing payers to further drive a clear and effective reimbursement strategy, contract renewal planning process, negotiation, implementation, and outcomes in relation to budgeted and forecasted performance requirements as set forth by national and local Division(s) senior leaders.
    • Establishes, and maintains positive, strategic interactions and relationships with payers, employers, and providers within the Division(s)
    • Engages in effective communication with internal stakeholders to ensure key contract terms and requirements are successfully implemented to ensure optimal contract performance
    • Recommends annual goals and reports progress each quarter
    • Stays current with emerging payer trends, new reimbursement methodologies, and State and National regulatory issues, plan benefits, payer activity, products and delivery channels including health insurance exchanges, market competition, etc.
    • Participates in establishing the composition, pricing, and management of fee and value-based payment and risk arrangements in support of CommonSpirit Health’s Healthier Communities strategy
    • Develops, implements, and maintains value-based payment and risk arrangements in conjunction with national standards & guidelines. 
    • Supports the strategic objectives of its IDNs, population health, and care management initiatives through directly engaging payers and employer customers, including CSH employee health benefits
    • Acts as Subject Matter Expert and thought leader regarding network asset and value creation in terms of affordability, access, and reputation for quality and outcomes
    • Participates in and contributes to CommonSpirit Health’s National Payer Strategy through sharing best practices, developing contract performance goals, key metrics, network development, reimbursement and language guidelines, revenue realization, and other applicable work streams
    • Collaborates with Advocacy

    Required Knowledge:

    • Demonstrated ability to set and maintain multiple priorities in an environment with shifting priorities, while providing accurate deliverables in a timely fashion.
    • Must be self-motivated, and able to take ownership of projects/assignments.
    • Must be a team player with excellent follow-up and customer service skills.
    • Will have strong leadership skills and will develop and maintain a high-functioning team
    • Possess strong strategic insights, financial acumen, analytical competencies, and strong negotiating skills
    • Strong interpersonal, verbal, and writing skills.
    • Interpersonal skills in dealing with internal/external stakeholders and team members


    Minimum Qualifications:

    • Ten (10) years of progressive managerial and strategic leadership experience in regional and/or national healthcare organizations.
    • Five (5) years direct strategic healthcare delivery and/or network management leadership roles.
    • Demonstrated success in leading, implementing, and managing network strategy and payer contract performance.
    • Demonstrated ability to work effectively in a matrix-oriented organization.
    • Demonstrated ability to effectively drive strategic transformation work.

    Required Education:

    • Master's or Post Graduate Degree



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