Manager Alternative Payment Models

Blue Cross and Blue Shield of Kansas is looking to add to our leadership team with the opportunity for a Manager Alternative Payment Models. This position carries the primary responsibility for development and implementation of provider alternative payment models and arrangements. To accomplish this, the position will collaborate with staff from other divisions on the continued development of... accountable care organizations, patient centered medical homes, quality-based reimbursement programs, collaborative care models, narrow networks and other reimbursement arrangements designed to improve quality and health outcomes and manage costs. "This position is eligible to work remotely (8 or less days a month onsite) or hybrid (9 or more days a month onsite) in accordance with our Telecommuting Policy. Applicants must reside in Kansas or Missouri or be willing to relocate as a condition of employment." Are you ready to make a difference? Choose to work for one of the most trusted companies in Kansas. Why Join Us? • Family Comes First: Total rewards package that promotes the idea of family first for all employees; including paid time off and family first leave. • Make a Positive Impact: Your work will directly contribute to the health and well-being of Kansans. • Stability: 80 years of commitment, compassion, and community • Inclusive Work Environment: We pride ourselves on fostering a diverse and inclusive workplace where everyone is valued and respected. • Lead and Inspire: Guide and mentor your team to achieve their full potential and success. Compensation $151,280 - $180,000 Exempt Grade 20 • Blue Cross and Blue Shield of Kansas offers excellent competitive compensation with the goal of retaining and growing talented team members. The salary range for this role is a good faith estimate, it is estimated based on what a successful candidate might be paid. All offers presented to candidates are carefully reviewed to ensure fair, equitable pay by offering competitive salaries that align with the individual's skills, education, experience, and training. The range may vary above or below the stated amounts. What you'll do • Directs the value-based programs staff in daily activities associated with proper administration of the programs and provider reimbursement. • Manages staff which includes interviewing, hiring, and/or termination of staff. Responsible for recommendations of adequate staff levels. • Manages the presentation of proposed changes in reimbursement study for alternative based payment models. Recommends changes and/or additions to value-based pricing structures for providers. • Manages the presentation of existing value-based models, new pricing methodology and value-based methodology for providers. Assists in the development of negotiation tools necessary for the provider contracting process. • Manages the procurement of financial data from providers and affiliated entities. Works directly with consultants, financial experts, employees of the providers. • Manages the research for and works directly with hospital and professional providers. • Manages the business tasks necessary to create reports/analysis tools utilized in the external and internal procedures related to the establishment of alternative payment model reimbursement. What you need • Bachelor degree in Mathematics or related degree with calculus and statistics courses. • Must have obtained the Associateship designation in the Society of Actuaries and membership in the American Academy of Actuaries. • Proven leadership experience. Bonus if you have • Fellowship designation or pursuit of the Fellowship designation from the Society of Actuaries is preferred. • Knowledge of quality-based and value-based models, reimbursement programs and/or care coordination practices. • Experience in management of health care delivery billing processes. Benefits & Perks • Base salary is only one component of your competitive Total Rewards package: • Incentive pay program (EPIP) • Health/Vision/Dental insurance • 6 weeks paid parental leave for new mothers and fathers • Fertility/Adoption assistance • 2 weeks paid caregiver leave • 5% 401(k) plan matching • Tuition reimbursement • Health & fitness benefits, discounts and resources Posting Close Date Pay Rate Type Salary Apply Job!