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Serve as the lead attorney for the company’s Value-Based Care business unit advising the VBC leadership team on legal and regulatory matters, risk management strategies, and contracting strategies.
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The Senior Corporate Counsel, NeueHealth Care Delivery will provide guidance on legal and regulatory matters, and support for contracting, with a focus on the operations of medical practices, MSOs, value based care, and networks.
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Minimum of fifteen (15) years with biopharmaceutical market access experience, including direct healthcare systems experience in a health plan environment including significant experience in network development, provider/third party payer contracting, value-based reimbursement, and the development of ACOs; in-depth knowledge of managed care regulations; solid understanding of health plan operations and how they think and make decisions.
$330,000 - $370,000 a yearFull-timeExpandApply NowActive JobUpdated Yesterday - UpvoteDownvoteShare Job
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Lead Global Value and Access function including Health Economics and Outcomes Research (HEOR), Trade and Distribution, Field based payer account management teams, pricing and contracting.
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Partner with existing clients to assure effective co-development and co-management of necessary market enablers for value-based care, e.g., governance, leadership development, network development, provider compensation models, and practice transformation, and physician IT enablement.
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In particular, the AVP will play a critical leadership role in the development of processes relating to Medicare risk adjustment, documentation, and in-home wellness assessments (in partnership with Humana's Medicare Risk Adjustment team, as well as with external strategic partners), given the importance of these areas to the delivery of value-based care.
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In collaboration with the Chief Medical Officer, SVP, Revenue Cycle and VP, Payor Contracting provide input on Value-Based Care (VBC) strategies, goals, and contracted incentive language to improve extraction of VBC incentives in the primary care environment.
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This role works directly with other clinical, network contracting, provider engagement and operational leaders to develop and optimize quality performance metrics to positively impact CCA's value based care strategies.
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Experience in legal support for medical practices and other provider groups, MSOs. Experience with risk based arrangements/value based care strongly preferred. medical practices, MSOs, value-based care, government programs and other third-party clients.
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Health care regulatory knowledge focusing on Fraud, Waste, and Abuse; knowledge of Value-based care, Medicare Advantage Organizations, ACO REACH and MSSP programs is required.
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This Director & Assistant General Counsel, Managed Care, Value Based Care, CIN and Malpractice role is primarily responsible for providing legal advice for Novant Health’s commercial managed care contracting, value-based care arrangements and clinically integrated networks.
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Executive leadership of Provider Performance and Analytics functions, supporting Humana's value based contracts and trend bender initiatives. The ideal candidate will have extensive business leadership experience, with several years in a managed care environment leading a network development/provider relations function, including proven experience leading contracting for Medicare products.
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The Director, Commercial Contracting on the Strategic Payer Partnerships team will execute Aledade’s commercial value-based care contracts with national and regional health plans as we help primary care providers shift into value-based care.
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With models ranging from home health to in home wellness assessments to in-home primary and acute care, the Home is a core part of Humana's overall integrated care delivery strategy, and we believe the Home is the next frontier in high touch, value-based care for our members.
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Significant experience with value-based primary care and/or home-centric care models. In addition to leading a team, a key crosscutting responsibility for the AVP will be owning executive and C-suite level relationships both across a diverse array of matrixed Humana teams (Retail Markets, MRA team, Contracting, DH&A, Home, etc.
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