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By harnessing existing data sets and utilizing advanced analytics to extract insights into payer behavior, we support our clients’ pricing, contracting, and market access strategies and develop creative and impactful ways to communicate the value of their products to reimbursement stakeholders.
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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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Partnering with Network and Segment teams to ensure deployment of VBC strategies are executed timelyPerform market competitive analysis, engage contracting and clinical teams to create innovative value based payment concepts.
$79,200 - $174,200Full-timeExpandApply NowActive JobUpdated Today - UpvoteDownvoteShare Job
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Oversee fee-for-service and value-based contracting activities for RI, oversight of managed care team, and manage payer contracts and relationships for all network hospitals, physicians, IPA and ancillary providers.
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Experience in Risk-based arrangements and Value-Based care in government servicesAdept at execution and delivery (planning, delivering, and supporting) skills. Experience in Value Based Care financial models.
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3) In collaboration with their supervisor and Market General Manager, works with external stakeholders including network providers and facilities to design models that improve care coordination, care delivery, metrics, outcomes, and accurate HCC coding for value-based contracts.
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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.
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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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The Manager of Payer Strategy & Engagement role will support the execution of Aledade’s strategic partnerships with national and regional health plans and healthcare-related organizations as we help primary care providers shift into value-based care.
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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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With more than 700 care sites across the U.S. from clinics and hospitals to home-based care and virtual care services CommonSpirit is accessible to nearly one out of every four U.S. residents.
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Oversee quality control and quality assurance of Payer Analytics & Economics analytics deliverables and financial models to support the negotiation and implementation of appropriate reimbursement rates associated language, between physicians/hospitals and payers/networks for managed care contracting initiatives.
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Strong knowledge of pharmaceutical products, healthcare systems, and value-based care models. Previous experience in value-based contract design, healthcare analytics, or managed care is preferred.
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Johnson & Johnson Health Care Systems Inc. is recruiting for an Associate Director, Pricing Strategy within its Strategic Customer Group (SCG) on the Value Access & Pricing (VAP) team for Retina and Pulmonary Hypertension to be based in Titusville, NJ.
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Deliver effective analytics with actionable insights to achieve best in class fee for service and value based care contract performance. Director - Actuarial Healthcare Analytics - Payor Contracting.
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