Manager Value Based Contracting - The HealthPlan

 
Position: Manager Value Based Contracting - The HealthPlan

Job ID: 156093

Location: US-TX-Bellaire

Department: Contract Administration

Talent Area: Professional - Non-Clinical

Full/Part Time: Full-Time

Regular/Temporary: Regular

Shift: 8am-5pm

About Texas Children's Hospital

Founded in 1996, Texas Children’s Health Plan is the nation's first health maintenance organization (HMO) created just for children. We provide STAR/Medicaid and Children's Health Insurance Program (CHIP) to pregnant women, teens, children and adults in Houston and surrounding areas. Currently, the Health Plan has more than 375,000 members who receive care from our network of more than 1,100 primary care physicians, 3,200 specialists, and 70 hospitals. Texas Children's Health Plan is also the largest combined STAR/CHIP Managed Care Organization in the Harris County service area.   To join our community of 14,000+ dedicated team members, visit texaschildrenspeople.org for career opportunities. You can also learn more about our amazing culture at infinitepassion.org.   Texas Children’s is proud to be an equal opportunity employer. All applicants and employees are considered and evaluated for positions at Texas Children's without regard to mental or physical disability, race, color, religion, gender, national origin, age, genetic information, military or veteran status, sexual orientation, gender identity, marital status or any other protected Federal, State/Province or Local status unrelated to the performance of the work involved.

Summary:

We are searching for a Value Based Contracting Manager for The HealthPlan-- someone who works well in a fast-paced setting. In this position, you will initiate, secure and monitor performance of value-based contracts with hospitals, physicians and other healthcare providers within the service area. You must have contract negotiating experience for this role.

 

Think you’ve got what it takes?



Responsibilities :

  • Develops the value-based contracting strategy in collaboration with the leadership team and implements the strategy
  • Manages complex negotiations, incorporating quality measures and risk-based reimbursement methodologies
  • Leads ongoing monitoring meetings with providers to review performance on value-based contracts
  • Leads internal workgroups to develop monitoring tools, dashboards and resources for providers who have value-based contracts
  • Ensures a timely response to all internal and external customer calls, faxes and emails received in the department email and phone queues, or received by individuals
  • Ensures that all assigned departmental deliverables are filed with TDI and HHSC timely and accurately and that all policies and procedures related to the deliverables are followed
  • Prepares and presents reports to leadership regarding the staff’s productivity, work quality and accuracy and makes recommendations for process improvements and/or resources estimates
  • Supports management through communication and ad hoc reporting


Qualifications:

  • Bachelor’s degree required
  • 6 years managed care experience in a contracting, provider relations or provider business office role required
  • Prior management or supervisory experience preferred
  • Prior value-based contracting experience is preferred


Apply Now
Current Texas Children’s employees – Please click here to login.
Create Profile or Log In Search Careers