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Nemours Children's Health · 1 day ago

Director, Global Budget Program-Population Health Management

Wilmington, DE

Full-time

Onsite

Lead/Staff, Director/Executive

5+ years exp

Nemours Children's Health is an internationally recognized children’s health system that provides medical care across five states. They are seeking a Director for the Global Budget Program to lead the implementation of global budget initiatives aimed at financial sustainability and quality metrics, overseeing Medicaid Revenue models and engaging with various stakeholders to ensure alignment with the organization's health strategies.

AssociationHealth Care

Responsibilities

Serves as a leading support to the Chief Population Health Officer and Chief Policy and Prevention Officer, supporting them and increasing their bandwidth to execute on the payment innovations to support whole child health aligning across population health, clinical services, and financial sustainability

Drives cross-functional strategic planning and execution of Pay-for-Health initiatives related to global budget

Supports Nemours’ Population Health Leadership for board-level discussions on financial sustainability, reimbursement transformation, and pediatric payment innovation

Facilitates enterprise-wide collaboration to integrate care delivery, financing, and risk-sharing models, positioning Nemours as a leader in pediatric accountable care

Directs the Global Budget Program, ensuring seamless and compliant execution with Delaware DMMA, MCOs, and internal stakeholders

Oversees baseline revenue setting, mid-year adjustments for case mix, service volumes, and policy changes, and year-end financial reconciliation

Coordinates cross-functional teams to monitor performance, manage retained savings allocation, and align financial outcomes with cost efficiency, quality targets, and population health objectives

Leads the financial oversight, reconciliation, and ongoing evaluation of the Delaware Valley Global Revenue Budget (DV GRB), ensuring that financial outcomes are aligned with policy objectives, cost efficiency, and health equity

Implements processes for ongoing performance monitoring, integration and ongoing planning

Manages vendor partnerships and consultant engagements, ensuring execution of risk-based and value-driven reimbursement strategies

Facilitates enterprise-wide governance structure, financial oversight, and executive reporting mechanisms to ensure cohesion in payment transformation

Establishes a cross-functional payment strategy framework, ensuring that actuarial, financial, and clinical teams remain aligned with Nemours' system-wide APM adoption

Supports and staffs the Enterprise Payment Integration Committee, a cross-functional governance structure with the CPHO, CFO, and COO, and other stakeholders, ensuring strategic alignment and advancing opportunities to scale and operationalize additional risk-based reimbursement models

Builds and executes multi-market expansion plans for Nemours’ payment model innovation strategy based on leadership direction

Leverages relationships with Nemours state and federal affairs teams to engage with state Medicaid leadership, federal regulatory bodies, and external actuaries to ensure financial sustainability and operational feasibility of all payment model innovations

Staffs Nemours leadership in industry-wide discussions on alternative payment models, value-based pediatric reimbursement, and total cost of care reform

Provides support for leadership to engage in HCP-LAN policy discussions, industry working groups, and national payment reform summits to drive Nemours’ influence in shaping the future of value-based pediatric care

Builds and leads Enterprise Global Budget work, supporting a high-performing team to drive system-wide payment transformation

Oversees budgeting, financial management, workforce management, and associate development while modeling Nemours corporate values and alignment with system objectives and compliance expectations

Other duties as assigned and necessary

Qualification

Financial modelingAlternative payment methodologiesRisk adjustmentPayer engagementActuarial analysisTotal cost of care benchmarkingEnterprise financial forecastingStrategic planningCommunication skillsTeam leadership

Required

Advanced Degree in healthcare management, health policy, medical economics, hospital finance, or related fields

More Than 5 Years Of Job Related Experience Required

Experience in financial modeling, alternative payment methodologies, risk adjustment, payer engagement, technical proficiency in actuarial analysis, total cost of care benchmarking, and enterprise financial forecasting