JOB OVERVIEW:Cardiovascular Services of America (CVAUSA) is the largest private and independent cardiology network in the United States. Our inclusive and diverse network brings together top cardiovascular specialists and thought leaders who offer regional perspectives and a broad strategic vision for the future of patient care.Novocardia, a division of CVAUSA, is on a mission to revolutionize cardiovascular care and empower clinicians across the United States to consistently deliver high-quality, prevention-focused, value-based, patient-centered care. Chronic disease is the dominant cause of avoidable healthcare spending and death in the United States and worldwide. Fortunately, much of this disease burden and associated spending is potentially avoidable through delivery of more proactive, prevention-focused care. We are deeply passionate about improving care quality, and providing more Americans with access to great, evidence-based chronic disease care.ESSENTIAL DUTIES AND RESPONSIBILITIES:The Director of Contracting - Value-Based Care Reports to the Chief Payor Relations Officer for Cardiovascular Associates of America (CVAUSA.com) and is responsible for the overall direction and management of the contracting cardiovascular focused value-based care (VBC) contract development and execution strategies for CVAUSA and Novocardia the value-based care division of CVAUSA. Responsibilities include negotiating provider reimbursement rates and contract terms, developing value-based care arrangements, planning, directing, organizing and evaluating the implementation of strategic objectives to ensure success in value-based contracts with payors and risk bearing provider organizations.  Ensures that contractual obligations are met for all value-based contracts. Formulates and implements policies and procedures to ensure compliance with applicable regulatory, contractual standards and requirements.

• Responsible for oversight of cardiovascular value-based contract development, negotiation and performance activities.
• Develop contract negotiation strategies to meet Strategic Goals for value-based and managed care contracting.
• With guidance, expand on the current Novocardia risk and value-based Contracting models with payors and risk  by partnering with new health care systems within Maryland and targeted states; implement programs and strategies related to manage care contracts.
• Lead, develop and implement alternative reimbursement methodologies (site of care, shared savings, risk sharing, and other new reimbursement arrangements
• Collaborate with key stakeholders, including finance, physician, practice leadership, leads, operations and legal, to manage financial and operational, and legal provisions of the contracts. Implement contracting processes to effectively manage and maintain contract proposal, renewals and analysis, contract execution and configuration.
• Knowledge of commercial products and government programs including Medicare, Medicare Advantage.
• Ensure compliance with state and federal regulatory requirements related to applicable state laws

JOB REQUIREMENTS AND QUALIFICATIONS:

• Bachelor’s degree in related field. Master’s degree in business in health care administration preferred.
• Work requires a professional level of knowledge in business administration and/or management as normally acquired through 5-7+ years managed care/health care experience with at least three of those years in a supervisory capacity.
• Work requires demonstrated experience in the managed care environment, such as an Integrated Health System in an administrative or finance setting or managed care organization/Insurance Company.
• Must have analytical and strong financial skills, contracting knowledge and over five (5) years of progressive management experience. Must have experience with data analysis and statistics. Requires proven experience engaging payors or providers in meaningful dialogue that results in collaborative relationships to support quality and financial initiatives.
• Knowledge of complex managed care concepts, including managed care contractual process; including alternative reimbursement models associated with incentive and risk-based programs.
• Demonstrated knowledge of value-based care reimbursement models. Healthcare contract experience in commercial and government contracting.
• Knowledge of multi-state and federal regulatory requirements. Broad contracting experience in unregulated markets.

Work Location: RemoteJob Type: Full-timeTime Zone:    EST or CST