The job below is no longer available.
You might also like
in Minnetonka, MN
$42est. per hour New Perspective • 9d agoUrgently hiring 18.3 mi Use left and right arrow keys to navigate- Autozone • 3d ago
Urgently hiring 7 mi Use left and right arrow keys to navigate - Autozone • 3d ago
Urgently hiring 7.2 mi Use left and right arrow keys to navigate 
Horizontal Talent • 6h agoUrgently hiring 6.3 mi Use left and right arrow keys to navigate- $65
est. per hour Consolidated Communications • 9h agoUrgently hiring 7.3 mi Use left and right arrow keys to navigate
Senior Director Payer Consulting Bundled Payment and Episode Based Payment - telecommute - Full-time / Part-time
•30 days ago
| Hours | Full-time, Part-time |
|---|---|
| Location | Minnetonka, MN Minnetonka, Minnesota |
About this job
Health care markets are rapidly moving to adopt new forms of provider reimbursement as a result of incentives created by the Affordable Care Act and the perceived deficiencies of current fee-for-service reimbursement models. Providers often view payment innovation as a strategy for establishing or maintaining market leadership. Health plans recognize that payment policies that place providers at risk for the cost and quality of their services represent an important strategy for managing their medical spend. At the same time, payment innovation is a fundamental component of health care reform and government officials are increasingly asserting a leadership role in testing and evaluating new payment models.
Optum is a leader in supporting innovative managed care contracting arrangements. Our prospective payment offerings are the most comprehensive and widely used solutions in the industry. We are also the market leader in episode grouping methodologies (i.e., ETGs®, PEGs®) and analytic solutions that use episode-based methods as their foundation. As the functional lines that separate providers and payers in the market continue to blur, it is essential that Optum respond by enabling providers and provider-sponsored organizations to implement payment models that take advantage of these unique resources.
This Director, Payment Innovation Solutions, is responsible for the design, development, delivery and business development of consulting services in support of episode-based payment models and similar payment innovations, with a special focus on providers and provider-sponsored organizations. Providers and provider-sponsored organizations face unique challenges in implementing episode-based payment arrangements. They usually do not have access to data that are needed to design appropriate episode constructs, data that describe the use of services across the continuum of care. They also often lack the analytic experience that health plans have developed in working with episode constructs and managing provider reimbursement systems. Provider and provider-sponsored organizations can also benefit from a better understanding of opportunities for success under new payment models, including approaches to transforming care delivery. Optum is creating this position to enable our consultants to support these organizations.
Responsibilities:
- Developing and managing the delivery of services to enable provider-sponsored organizations to pursue various payment innovations, especially those involving episode-based payment models
- Industry thought leader in payment innovation, especially in terms of episode-based payment models
- Achieving specific revenue and IOI targets while collaborating with other consulting activities within the NPH pillar relating to payment innovation
- Lead development of new consulting products and services to meet emerging customer needs
- Lead client teams to deliver a variety of services relating to payment innovation
- Ensure quality and performance are established and measured with improvement goals developed
- Work as a member of the Network Analytics leadership team to achieve revenue and IOI objectives
Requirements
- Subject matter expertise in provider payment models, especially code-based reimbursement methods such as prospective payment and episode-based payment
- Demonstrated expertise in quantitative methods applied to health care claims and/or encounter data
- 15+ years of health care experience in progressively more complex roles
- A minimum of 5 years of experience in externally-facing roles such as consulting or managed care contracting
- Experience and credibility interacting with c-level executives, including medical directors and network management leadership
- Master's degree in business, health services, public health or equivalent is preferred
- Prior consulting experience, especially in a leadership position, is preferred
- Ability to travel up to 50%
Careers with Optum. Here's the idea. We built an entire organization around one giant objective; make health care work better for everyone. So when it comes to how we use the world?s large accumulation of health-related information, or guide health and lifestyle choices or manage pharmacy benefits for millions, our first goal is to leap beyond the status quo and uncover new ways to serve. Optum, part of the UnitedHealth Group family of businesses, brings together some of the greatest minds and most advanced ideas on where health care has to go in order to reach its fullest potential. For you, that means working on high performance teams against sophisticated challenges that matter. Optum, incredible ideas in one incredible company and a singular opportunity to do your life's best work.SM
Diversity creates a healthier atmosphere: All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, protected veteran status, or disability status.
UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment. In addition, employees in certain positions are subject to random drug testing.
keywords:
Healthcare consulting, consultant, bundled payment, provider, payer, episode, episode based, episode based payment, payment, retrospective, prospective
Your Privacy Choices