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Sr. Director, Health Policy & Value-Based Payment Strategy

Description

UPMC Health Plan has an exciting opportunity to design and implement the Health Plan's value-based payment policy as the Sr. Director of Health Policy & Value-Based Payment Strategy.  This role will bring specific expertise in value-based healthcare payment strategies and insurance product design to the health policy and regulatory affairs team and use this expertise to assist the Insurance Services Division in the development of innovative, value-based strategies and products. As a member of the Health Policy and Regulatory Affairs team, the Sr. Director will monitor, gather, assess and evaluate industry trends specific to value-based design and will assist the executive team in the development of innovative value-based products, services and payment strategies.

Responsibilities:

  • Monitor, gather, assess, and analyze industry trends in value-based design.Assist the executive team in the development of innovative value-based products, services and payment strategies.
  • Maintain robust external, strategic relationships to gain ongoing competitive insights relative to emerging payment methodologies and value-based strategies.Strategically apply extensive knowledge of provider reimbursement and health care finance to support the development of new and innovative coverage products and provider payment.
  • Build relationships with senior key stakeholders to ensure that strategic business goals are met through the sharing of knowledge and expertise.
  • Closely collaborate with, among others, the Departments of Health Economics, Finance, and Contracting & Reimbursement to prepare best-in-class critical analysis, presentation, and identification of strategic opportunities to support rapid cycle development of innovative product and payment solutions.
  • Independently develop high quality presentations, white papers, regulatory comments and other similar materials for potential publication.Skillfully represent UPMC Health Plan and the Insurance Services Division through demonstration of thought leadership and expertise before a range of internal and external stakeholders and venues.
  • Manage critical issues, taking leadership for the regulatory interface, competitive analysis, product development and health policy contributions.Align business development activities and resources with business strategies and regulatory requirements.

Qualifications

  • Bachelors degree required.
  • Minimum of 5 years' experience in health policy and finance, with an emphasis on value-based reimbursement and/or product design strongly preferred.
  • Exceptional business acumen specific to the development of new and innovative value-based strategies and design.
  • A solid understanding of hospital and provider payment methodologies and health care finance.
  • Knowledge of current landscape trends in health care and pharmaceutical reimbursement methodologies and quality measurement among commercial and governmental payers.
  • Exceptional analytic and writing skills.
  • Ability to function as a member of a busy, fast-paced and collegial policy/GR/legal team.


Licensure, Certifications, and Clearances:

UPMC is an Equal Opportunity Employer/Disability/Veteran

 

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