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Equality Health · 2 days ago

Sr Director/Vice President, Affordability

United States

Full-time

Remote

Director/Executive

10+ years exp

Equality Health is an integrated healthcare delivery system focused on improving health and wellness for diverse populations. The Head of Affordability will lead the company's medical cost management strategy, identifying and managing opportunities to enhance value-based care for Medicaid populations.

Health CareHospitalMedicalRisk Management

Responsibilities

Lead end-to-end identification and sizing of medical cost opportunities

Partner with Analytics, Actuary, and Finance on cost driver and utilization analysis at the contract, rate cell, and category of aid levels

Develop ongoing pipeline of interventions based on size and addressability of opportunities

Maintain a forward-looking view of emerging cost risks at both macro / industry level and micro / market / payor level

Partner with clinical and medical directors to assess clinical addressability of cost opportunities using evidence-based guidelines

Develop and maintain a prioritized affordability roadmap

Evaluate opportunities based on size, speed, complexity, and channel

Lead execution of affordability initiatives across provider network, direct care, and vendor channels

Define plans, timelines, and success metrics for each intervention

Establish and manage relationships with vendors where utilized to deliver interventions

Produce measurement framework for affordability initiatives and present monthly report during executive monthly operating review analyzing pipeline, execution, and any adjustments and / or investments required to achieve affordability targets

Evaluate and manage external vendor partners engaged to deliver affordability interventions

Demonstrate first-rate collaboration skills to marshal capabilities across the enterprise to deliver affordability targets

Demonstrate influence across functions you don’t control

Communicate effectively internally and externally to build support and demonstrate value delivered