This leader will work collaboratively with Payor Relations leadership to facilitate an understanding of emerging market trends, strategic decisions being made, and will also support the negotiation planning and execution process.

• Position: AVP, Strategy, Financial Projections & Analytics
• Location: Skokie, IL
• Full Time/Part Time: Full Time
• Hours: Monday-Friday, normal business hours

• Education: Bachelor’s Degree in Finance, Accounting, Business Administration, or related field, required. Master’s degree, preferred.
• Experience:
  • 10+ years of experience in payor relations and reimbursements.
  • 6+ years of leadership experience.
• Skills:
  • Demonstrated leadership and management skills.
  • Advanced computer literacy.
  • Understand NPI rules and concepts.
  • Understand Facility credentialing and enrollment concepts.
  • Understand cloud native architectures, patterns, application deployments and operations.
  • Ability to work independently, communicate proactively, and manage multiple projects.
  • Strong analytical and interpersonal skills.
  
  

• Develop and provide strategic direction for payor partnerships, reimbursement models, value-based care/risk expansion for the Clinically Integrated Network (CIN), network design, and fee for service opportunities.
• Collaborate with Payor Relations team to understand functional area challenges and opportunities and how to incorporate those challenges into the strategic plan.
• Maintain a thorough knowledge of reimbursement methodologies, contractual terms, billing, credentialing/rostering and other operational factors needed for contracting and framing of strategy.
• Maintain a thorough knowledge of industry trends, emerging managed care opportunities and education and communicate this knowledge to Payor Relations Leadership and others as necessary.
• Create and maintain Payor Relations strategic plan that addresses variation of goals for Commercial Insurance, ACA coverage, Government products, and value based care risk expansion.
• Participate in the contract negotiations as necessary.
• Oversee the Analyst function and ensure data needs are being met.
• Oversee Financial Projections, and Value Based Care Agreement performance, including development of “what if” scenarios and complex modeling.
• Oversee Contract Analytics via our Cost Accounting Tool (Strata) inclusive of Strata related modeling and coordinate modeling activities with Lead, Fee for Service.
• Participate in the annual budget process regarding expected fee for service revenue and value based care reimbursement to support CIN.
• Build deep relationships with the senior technical individuals within the organization to enable them to be advocates.
• Provide training and mentorship to new and existing employees that support Strategy, Financial Projections/Performance and Analytics
• Negotiates favorable contracts with various payors using a diverse range of techniques and contracting best practices.

Diversity, equity and inclusion is at the core of who we are; being there for our patients and each other with compassion, respect and empathy. We believe that our strength resides in our differences and in connecting our best to provide community-connected healthcare for all.