Job Description

Description

UNC Health Alliance is UNC Health's statewide clinically integrated network and population health services organization. The mission of this team is to transform healthcare delivery on behalf of more than 8,000 providers by offering patient-centered solutions to populations covered under alternative payment models. Joining this team means you will work closely with providers, practices, payers, business leaders, and community partners to improve the quality and accessibility of care while lowering the cost of care for patients, payers, and businesses. We are a growing team looking for top talent to help us with creative solutions that improve patient care and help make healthcare more affordable. Become part of an inclusive organization with over 40,000 diverse employees, whose mission is to improve the health and well-being of the unique communities we serve.

Job Summary:

This position has responsibilities for evaluating, negotiating and administering value-based care contracts and alternative payment models. Employees perform the full range of functions associated with value-based care contracting.

Description of Job Responsibilities:

1. Analysis. Identifies key information needs, as well as researches and analyzes data to provide necessary information. Analyzes financial, contractual and operational issues related to current and prospective value-based payer programs. Conducts due diligence and performance assessments on potential value-based payers or partners.

2. Value-Based contract management. Maintains primary responsibility for value-based relationships with select payers. Ensures all parties are complying with terms of the contracts. Facilitates contract management and problem resolution. Creates and generates applicable performance projections or reports, communicates all information to affected parties, including clinic and administrative staff, physicians and management.

3. Education & Communication. Relays contractual, policy, systems and procedural requirements and the effects of non-compliance to relevant clinical and administrative leaders. Directs the design of communications and educational materials based on the contract or design of the alternative payment model. Serves as key resource and information source related to value-based care contracts.

4. Health care market assessment. Assesses developing trends in the health care environment and forecasts their impact on UNC Health Alliance stakeholders, assists in formulating strategies for responses to market changes. Stays current with new managed care product and alternative payment model development and communicates potential strategies for maintaining market readiness.

5. Value-based care contract negotiation. Manages the end-to-end contracting process including evaluating and negotiating the terms of proposed value-based care agreements and alternative payment models. Discusses draft contracts with appropriate clinical and administrative stakeholders, establishes contract expectations, obtains legal review of documents and negotiates terms with value-based payers.

Other Information

Education Requirements:

• Bachelor's degree in an appropriate discipline.

Professional Experience Requirements:

• If Bachelor's, four (4) years of value-based care experience required.
• If Associate's, eight (8) years of value-based care experience required.
• If High School Diploma, twelve (12) years value-based experience required.

Four (4) years of value-based care contracting experience preferred.

Knowledge/Skills/and Abilities Requirements:

Knowledge of managed care organizations, commercial & government payers, contracts, and products. Thorough knowledge of, and ability to apply, applicable policies and regulations governing managed care organizations and third party reimbursement plans. Knowledge of, and demonstrated ability to implement, the principles and practices associated with business negotiations. Knowledge of the key operational processes and systems impacted by alternative payment models.
Job Details

Legal Employer: NCHEALTH

Entity: Health Alliance

Organization Unit: HA Central Administration

Work Type: Full Time

Standard Hours Per Week: 40.00

Salary Range: $32.23 - $46.33 per hour (Hiring Range)

Pay offers are determined by experience and internal equity

Work Assignment Type: Remote (with occasional onsite meetings)

Work Schedule: Day Job

Location of Job: US:NC:Morrisville

Exempt From Overtime: Exempt: Yes

This position is employed by NC Health (Rex Healthcare, Inc., d/b/a NC Health), a private, fully-owned subsidiary of UNC Health Care System, in a department that provides shared services to operations across UNC Health Care; except that, if you are currently a UNCHCS State employee already working in a designated shared services department, you may remain a UNCHCS State employee if selected for this job.

Qualified applicants will be considered without regard to their race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or status as a protected veteran.

UNC Health makes reasonable accommodations for applicants' and employees' religious practices and beliefs, as well as applicants and employees with disabilities. All interested applicants are invited to apply for career opportunities. Please email [email protected] if you need a reasonable accommodation to search and/or to apply for a career opportunity.