Starting Salary - $108,885.92 May go up depending on experience.
POSITION SUMMARY
The Senior Director of Payment Reform Initiatives works closely with the Strategy & Payer Relations Officer to direct payment reform initiatives. A primary responsibility of the role will be leadership in the implementation and ongoing success of Michigan’s Prospective Payment System (PPS) Alternative Payment Methodology (APM). The Senior Director of Payment Reform Initiatives works with all stakeholders to assess and understand educational needs, provide educational sessions, develop and convene meetings, demonstrate the impact and value of various payment reform initiatives, and promote and organize related advocacy. They design strategies to optimize the continued transition away from fee-for-service to innovative payment and clinical models that improve health outcomes and financial sustainability; actively research reimbursement innovations, and monitor the current landscape of local, national, and Federal payment and clinical models.
RESPONSIBILITIES AND DUTIES
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Leads, oversees and supports implementation and evolution of Michigan’s PPS APM.
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Proactively organizes and facilitates key stakeholder meetings and trainings for PPS APM including creating times that work, drafting agendas, and preparing and editing meeting minutes and presentations.
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Designs and directs the content development of events and trainings, webinars, facilitation of peer-to-peer networking, and provision of resources, as needed, to enhance PPS APM knowledge and broader awareness and understanding of all payment reform initiatives.
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Maintains and manages the project calendar, including all contact lists.
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Leads development of program communication and contributes to coordination and integration of external communication pertaining to PPS APM in order to improve program effectiveness and promote member engagement.
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Contributes to the development and maintenance of member relations and knowledge management tools
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Responsible for internal documentation and tracking of program progress.
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Act as a thought partner on new program strategy and design in order to promote alignment, coordination and integration across programs, and ensure effectiveness of implementation plans and advancement of organizational priorities.
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Monitors external program and policy developments in complex innovation, integration, and social determinants of health landscapes.
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Leads and manages work requiring innovative solutions and high levels of detail and complexity, with MPCA and health center staff.
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Supports modeling and analysis of various APM model decision points (services included, baseline years, etc.)
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Oversees and conducts financial impact analysis and projections, working with contractors as appropriate, on items such as independent rate validation for the APM.
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Reviews and develops comments and recommendations on DHHS state plan amendments, policies, and manual documentation related to APMs.
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Organizes and promotes advocacy, alongside government affairs staff, related to payment reform initiatives.
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Ongoing proactive research, analysis, and contribution to strategies driving the adoption of emerging innovative payment models across all payer types.
KNOWLEDGE, SKILLS AND ABILITIES
Requires Knowledge of:
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Michigan’s health coverage landscape including common public and private payers
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Michigan’s health and human services infrastructure
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Michigan’s Medicaid program
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Federally Qualified Health Center Reimbursement
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Value Based Care concepts and models
Skill/Ability to:
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Strong interpersonal communication skills with the ability to tactfully and effectively communicate complex and technical information, both written and verbal, in a professional manner that supports the ability to establish and maintain effective working relationships across all levels of MPCA and external stakeholders.
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Strong organizational skills, the ability to prioritize, and the ability to coordinate multiple projects with minimal supervision.
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Ability to work in team settings to show flexibility and versatility.
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Ability to learn additional software applications.
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Ability to self-motivate and thrive in a complex and rapidly changing environment.
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Ability to work with strict confidentiality requirements, as well as utilize good judgment in the preparation and distribution of confidential information.
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Ability to collect, analyze, compile and interpret technical and/or statistical data
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Ability to develop a plan of action and assume accountability for outcomes when working with Health Center partners or other stakeholders.
Education/Experience:
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Bachelor’s degree in a relevant field such as public health, health policy, healthcare administration, business administration, and/or a relevant combination of education and work experience. Master’s degree preferred.
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At least three years of professional experience working in health policy, health and human services organizations, or a related field, preferred
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Experience working in an FQHC strongly preferred
MPCA Diversity, Equity, and Inclusion Statement
MPCA is committed to fostering, cultivating, and preserving a culture of diversity, equity, and inclusion.
Our human capital is our most valuable asset. The collective sum of our individual differences, life experiences, knowledge, inventiveness, innovation, self-expression, unique capabilities, and talent that our employees invest in their work, represents a significant part of our culture, our reputation, and success.
We embrace and encourage our employee’s differences in age, color, ability ethnicity, family or marital status, gender identity or expression, language, national origin, physical and mental ability, race, religion, sexual orientation, socio-economic status, veteran status, and in other characteristics that are both protected, and not protected by state or federal law.
We are committed to leading by example and maintaining an equitable and inclusive work environment built on mutual respect and integrity.