Spectrum Health Value Based Payment Program Manager, Senior (Priority Health) in Grand Rapids, Michigan

Facility: Priority Health - GRAND RAPIDS, MI

Department: Ph-Value-Based Payment

Category: Health Plan

Classification: Full-time with Benefits (A1)

Are you passionate about transforming the healthcare industry and improving the health and lives of people across the state of Michigan? We are looking for a healthcare professional to join our Value-Based Payment team at Priority Health. This individual will work closely with stakeholders across the organization to lead program management for a portfolio of health plan programs/projects focused on the area of value-based payment.

What to expect:

  • Partners with other teams to create the overall conceptualization, strategy alignment, and high-level design of new value-based payment models

  • Manages a portfolio of pay-for-value programs for interdisciplinary teams to use in moving Accountable Care Networks (ACNs) toward achieving higher quality and decreased costs

  • Defines new themes for reimbursement innovation based on an understanding of healthcare innovation and trends in reimbursement from across the country

  • Uses skills in ideation, facilitation, strategic planning and relationship management to bring together multiple teams in the organization and create cohesive plans for execution

  • Serves as the subject matter expert on programs in the pay-for-value portfolio

  • Presents on pay-for-value topics to internal stakeholders and the provider network

  • Consults with internal interdisciplinary teams on the execution of portfolio programs in the network

Works closely with finance, actuary and reimbursement operations to perform business planning, including ROI analysis, for potential payment programs and determines effectiveness of current programs in the market

*Basic Qualifications:

Education - Bachelor's Degree or equivalent

Experience - 5 years of experience typically gained through skills/knowledge/abilities in health plan, managed care or healthcare delivery, administration or clinical practice management

Preferred Qualifications:

Education - Master's Degree or equivalent. MBA, MPH, MHSA, MPA or similar degree preferred.

Experience - Past experience in healthcare delivery, health insurance, contracting, finance, program management, or project management.

Spectrum Health grants equal employment opportunity to all qualified persons without regard to race, color, national origin, sex, disability, age, religion, genetic information, marital status, height, weight, sexual orientation, veteran status, or any other legally protected category.