Value Based Payment Manager
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*Bonus available to new employees and may require previous work experience. Employment commitment to Samaritan is required.
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Samaritan Health Plans (SHP) provides health insurance options to Samaritan employees, community employers, and Medicare and Medicaid members. SHP operates a portfolio of health plan products under several different legal structures: InterCommunityHealth Plans, Inc. (IHN) is designated as a regional Coordinated Care Organization (CCO) for Medicaid beneficiaries; Samaritan Health Plans, Inc. offers Medicare Advantage, Commercial Large Group, and Commercial Large Group PPO and EPO plans; SHP is also the third-party administrator for Samaritan Health Services’ self-funded employee health benefit plan.
As part of an Integrated Delivery System, Samaritan Health Plans is strategically and operationally aligned with Samaritan Health Services’ mission of Building Healthier Communities Together.
Preferred candidates will reside in Oregon.
This is a remote position in which we are able to employ in the following states: Alabama, Alaska, Arizona, Arkansas, Connecticut, Florida, Georgia, Idaho, Indiana, Iowa, Kansas, Kentucky, Louisiana, Maryland, Michigan, Mississippi, Missouri, Montana, Nebraska, Nevada, New Hampshire, New Mexico, North Carolina, Oklahoma, Rhode Island, South Carolina, South Dakota, Tennessee, Texas, Utah, Virginia, West Virginia, or Wisconsin
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JOB SUMMARY/PURPOSE
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Leads the development of premiums, innovative payment methodologies, capitated revenues and payments, and related financial processes, reporting, and analysis. Manages and develops assigned staff including external Actuaries or other contracted expertise. Leads Medicare and Medicaid revenue development and cascading related financial and operational implications to the organization. Analyzes VBP performance and presents results to internal and external stakeholders while driving long term VBP strategies. Oversees Actuarial analysis of revenue and cost to identify trends, outliers, risks, and financial opportunities.
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DEPARTMENT DESCRIPTION
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Samaritan Health Plans (SHP) operates a portfolio of health plan products under several different legal structures: InterCommunity Health Plans, Inc. (IHN) is designated as a regional Coordinated Care Organization (CCO) for Medicaid beneficiaries; Samaritan Health Plans, Inc. offers Medicare Advantage, Commercial Large Group, and Commercial Large Group PPO and EPO plans; SHP is also the third-party administrator for Samaritan Health Services’ self-funded employee health benefit plan. As part of an Integrated Delivery System, Samaritan Health Plans is strategically and operationally aligned with Samaritan Health Services’ mission of Building Healthier Communities Together.
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EXPERIENCE/EDUCATION/QUALIFICATIONS
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Bachelor's degree in Finance, Accounting, Economics or a closely related field required. MBA preferred.
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Five (5) years progressively responsible experience in financial analysis required. Experience in a healthcare setting preferred.
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Two (2) years leadership experience required.
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Experience or training in the use of accounting, financial and business software applications including Excel, Word and Access required.
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KNOWLEDGE/SKILLS/ABILITIES
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Leadership - Inspires, motivates, and guides others toward accomplishing goals. Achieves desired results through effective people management.
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Conflict resolution - Influences others to build consensus and gain cooperation. Proactively resolves conflicts in a positive and constructive manner.
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Critical thinking – Identifies complex problems. Involves key parties, gathers pertinent data and considers various options in decision making process. Develops, evaluates and implements effective solutions.
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Communication and team building – Leads effectively with excellent verbal and written communication. Delegates and initiates/manages cross-functional teams and multi-disciplinary projects.
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PHYSICAL DEMANDS
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Rarely
(1 - 10% of the time)Occasionally
(11 - 33% of the time)Frequently
(34 - 66% of the time)Continually
(67 – 100% of the time)LIFT (Floor to Waist: 0"-36") 0-20 Lbs
LIFT (Knee to chest: 24"-54") 0 - 20 Lbs
LIFT (Waist to Eye: up to 54") 0 - 20 Lbs
CARRY 1-handed, 0 - 20 pounds
CARRY 2-handed, 0 - 20 pounds
KNEEL (on knees)
BEND FORWARD at waist
CLIMB - STAIRSSTAND
WALK - LEVEL SURFACE
ROTATE TRUNK Standing
REACH - Upward
PUSH (0-20 pounds force)
PULL (0-20 pounds force)SIT
ROTATE TRUNK Sitting
REACH - Forward
MANUAL DEXTERITY Hands/wrists
FINGER DEXTERITY
PINCH Fingers
GRASP Hand/FistNone specified
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