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Director Government & Value-Based Programs

Req #:  116665
Facility:  Advocate Physician Partners
Department:  Management/Supervisory
City:  Rolling Meadows
Posting Budget Status:  Day
Shift Type:  Full Time - Permanent
Posting FTE:  1

Position Requirements:

  • Master's Degree in Business or related field.
  • Typically requires 7 years of experience in physician organization or managed care.
  • Includes 3 years of management experience in government programs.
  • Maintains strong knowledge of Medicare Payment Reform/MACRA, CMS and CMMI initiatives, and Medicaid health policy and regulations.
  • High aptitude for problem solving and ability to facilitate and lead activities with passion and maintain group energy.
  • Significant knowledge and experience in CQI principles.
  • Strong leadership, communication, and mentorship skills.
  • Ability to work in a highly matrixed organizational structure.
  • Commitment to continuous learning.
  • Will generally be exposed to a normal office environment.


Purpose:
Responsible for leading various government programs (both Federal and State) for Advocate Aurora Healthcare and for executing strategic oversight of deploying necessary Population Health tactics across Enterprise to deliver improved cost reduction and financial performance in Advocate Aurora's Value Based contracts. Has primary oversight of Medicare Shared Savings Program (MSSP) Accountable Care Organizations (ACO) including Track 1, Track 1+, and Track3, Bundled Payments for Care Improvement-Advanced (BPCI-A), Comprehensive Care for Joint Replacement (CJR) bundles, and any additional Centers for Medicare/Centers for Medicare and Medicaid Innovations (CMS/CMMI) new opportunities/programing. Has primary oversight of value based innovation projects to improve care delivery processes for patients and clinicians served under value based payer relationships, which includes monitoring key performance indicators, allocation of resources, and building strategic internal and external partnerships to deliver value. Collaborates with Enterprise finance and analytics teams to gain understanding of sources of variation in financial performance in order to drive improvement.

Accountabilities:

  1. Oversees and leads all key directives related to management of Medicare MSSP Track 1, Track 1+, and Track 3 ACOs, BPCI-A, and CJR programs for Advocate Aurora Health, including ongoing reporting and communications with CMS.
  2. Supports development and implementation of strategic plan for Advocate Aurora Government Programs including merging of programs and departments and identifying new CMMI opportunities/programming.
  3. Identifies, pilots, and strategizes how to scale new value based innovations related to Advocate Aurora's Value Based programs, which includes but is not limited to developing a business concept/plan, obtaining appropriate administrative support and funding, and partnering with Enterprise stakeholders to deploy the solution.
  4. Oversees development of utilization/cost metrics and processes to successfully track improvement and maintain feedback loops with appropriate stakeholders for Advocate Aurora's Risk Based programs, which includes but is not limited to strategically leading a multi~disciplinary groups of Enterprise leaders (utilization improvement, PHO Directors, Medical Directors, Care Management, Hospital Operational leaders, etc.) to appropriately plan, manage, and sustain utilization improvement programs.
  5. Provide leadership to identify utilization improvement and medical economic tactics that will deliver improved financial and quality  results based on local and national market trends. Work with the PHO Regional Medical Directors to create the agenda and provide the business support to the AAH Medical Economics Committee.
  6. Participate in Value Based programs financial meetings, and MSSP ACO national and regional meetings to learn industry trends and gain expertise on medical economic opportunites and innovations.
  7. Proactively monitors and engages federal and state agencies in the development and implementation of health care regulation; identifying internal stakeholders and experts, coordinating comment letters, drafting testimony and managing follow up for internal audiences.
  8. Direct oversight over the Government Programs Manager, the Medical Economics and Value Based Programs Manager, their respective teams, and a project manager.


Nearest Major Market: Chicago