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Payment Model Domain Expert, Woodlawn, MD or McLean, VA
Our client is seeking a Payment Model Domain Expert for a direct-hire opportunity in Woodlawn, MD or McLean, VA.
Our client is engaged in improving healthcare through the process of payment and delivery system reform and supports the Centers for Medicare and Medicaid Services (CMS) in its major initiatives to reform the delivery and payment of health care services. Our client is looking for a thought leader with substantial experience shaping alternative payment model project initiatives to meet national needs, working collaboratively with national health care leaders in the public and private sectors.
- Mastery of, and experience with, methodologies and challenges related to healthcare payment models, including model development, risk adjustment, and impact analysis, and small-scale testing.
- National reputation for expertise in health care finance and economics, including Medicare payment systems, rules, and regulations. Deep expertise with other CMS programs, most notably Medicaid, as well as private payer financial systems and rules is highly desirable.
- Analyze, develop and evaluate new payment models in partnership with federal, state, and private-sector sponsors and stakeholders.
- Noteworthy contributions to one or more major approaches to delivery system reform, including but not limited to consumer-directed models, physician specialty models, and Medicare Advantage innovations. Contributions involving multiple CMS programs and private payers is highly desirable.
- Leadership in consulting on, and/or working with, government health care programs to develop enterprise-level solutions to support major initiatives is highly desirable.
- Strong track record in consulting and engaging directly with public and private sector leaders to understand issues, risks, and objectives of health care initiatives. Ability to collaboratively work with public and private sector experts and team leaders to define the optimal path forward, the plan, and the strategy for achieving the desired goals.
- Adept at communicating complex concepts to a variety of audiences to achieve understanding and consensus.
- Conduct listening sessions, interviews, working sessions, and report-outs across the public and private health sector.
- Develop industry, market, competition, and financial analysis.
- Working collaboratively with fellow team members, stakeholders and our sponsors.
- Develop early career members of the team.
- At least 15 years of experience in health care research and project leadership.
- At Least 8 years of broad based recent health insurance/healthcare experience with specific experience in the design, implementation, and/or evaluation of alternate payment models.
- Direct experience with contributing to the analysis of sponsor needs, development of business strategies, and serving as a liaison to senior executives, external stakeholders, and healthcare sponsors.
- Advanced degree in economics, medicine or healthcare, statistics, healthcare policy, public policy, or related discipline.
- Distinguished record of contributions to healthcare research and reform, including peer-reviewed publications; leadership in health care policy initiatives as a consultant, government leader, or policy expert.
- Only those individuals selected for an interview will be contacted.
- No calls, inquiries, or Third Party Vendors please.
- We are an equal opportunity employer (Unable to sponsor H1B Visas).
Since 1988, The ACI Group, a national IT staffing firm, has been committed to hiring the industry’s leading professionals and presenting exciting career opportunities. We have access to varied types of contract, permanent and contract-to-perm positions and offer a choice of employment options including a full benefits package.
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