Director - Value-based Performance, Commercial and Managed Medicare/Medicaid Pay

We've made a lot of progress since opening the doors in 1942, but one thing has never changed - our commitment to serve, heal, lead, educate, and innovate.  We believe that every award earned, every record broken and every patient helped is because of the dedicated employees who fill our hallways.  At Ochsner, whether you work with patients every day or support those who do, you are making a difference and that matters.  Come make a difference at Ochsner Health and discover your future today! This job identifies opportunities promoting cost and quality improvement across the organization's suite of value-based contracts, including but not limited to commercial payors, Medicare Advantage, Medicare Shared Savings Program, and Medicaid value-based programs. Guides the company's progress toward compliance success with various quality and cost metrics and benchmarks. Provides focused direction and promotion of value-based care issues and initiatives, navigating across the numerous facets of the company, its health network participants, government agencies and external stakeholders.To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable qualified individuals with disabilities to perform the essential duties.This job description is a summary of the primary duties and responsibilities of the job and position. It is not intended to be a comprehensive or all-inclusive listing of duties and responsibilities. Contents are subject to change at the company's discretion.EducationRequired –  Bachelor’s degree in business administration, finance, economics, healthcare or related field.Preferred – Master’s degree in health administration, business administration or related field.Work ExperienceRequired – 5 years of program or personnel management experience in a large healthcare organization.Knowledge Skills and Abilities (KSAs)Ability to drive change working across varied departments and organizations.Ability to share visions and generate results.Ability to manage vendor relationships related to the role.Ability to create financial models and budgets.Ability to develop and execute strategic initiatives and drive performance through alternative payment models or clinical integration.Strong verbal and written communication skills and ability to effectively flex the style and content to reach varied audiences.Strong computer skills and working knowledge of software, including salesforce, Microsoft office, tableau, etc.Working knowledge of changing research, regulations and bills.Ability to decipher large amounts of information and make strategic decisions.Job DutiesTranslates clinical and financial data into action plans and accountability initiatives across the network.Works with practices, regions, and service line leaders to determine opportunities for cost and quality improvement under Value Based agreements.Establishes substantial integration across departments including but not limited to analytics, IS, legal & compliance.Acts as a liaison to commercial and Medicare payors, CMS, Medicaid and other governmental agencies to mitigate the significant regulatory, financial and operational risk of participation in the various programs.  Oversees the research, modeling and applications for continued participation and/or new contracts or program opportunities for our patients, members and beneficiaries.Oversees the annual operating budget and establishes processes to track quality, cost and utilization within the program.Effectively communicates innovations within the various program to drive results and achieve shared savings.Performs other related duties as required. The above statements describe the general nature and level of work only. They are not an exhaustive list of all required responsibilities, duties, and skills. Other duties may be added, or this description amended at any time.Remains knowledgeable on current federal, state and local laws, accreditation standards or regulatory agency requirements that apply to the assigned area of responsibility and ensures compliance with all such laws, regulations and standards.This employer maintains and complies with its Compliance & Privacy Program and Standards of Conduct, including the immediate reporting of any known or suspected unethical or questionable behaviors or conduct; patient/employee safety, patient privacy, and/or other compliance-related concerns.The employer is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, protected veteran status, or disability status.Physical and Environmental DemandsThe physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job.  Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.Light Work - Exerting up to 20 pounds of force occasionally, and/or up to 10 pounds of force frequently, and/or a negligible amount of force constantly (Constantly: activity or condition exists 2/3 or more of the time) to move objects. Physical demand requirements are in excess of those for Sedentary Work. Even though the weight lifted may be only a negligible amount, a job should be rated Light Work: (1) when it requires walking or standing to a significant degree; or (2) when it requires sitting most of the time but entails pushing and/or pulling of arm or leg controls; and/or (3) when the job requires working at a production rate pace entailing the constant pushing and/or pulling of materials even though the weight of those materials is negligible. NOTE: The constant stress and strain of maintaining a production rate pace, especially in an industrial setting, can be and is physically demanding of a worker even though the amount of force exerted is negligible.Normal routine involves no exposure to blood, body fluid or tissue and as part of their employment, incumbents are not called upon to perform or assist in emergency care or first aid.The incumbent has no occupational risk for exposure to communicable diseases.Because the incumbent works within a healthcare setting, there may be occupational risk for exposure to hazardous medications or hazardous waste within the environment through receipt, transport, storage, preparation, dispensing, administration, cleaning and/or disposal of contaminated waste. The risk level of exposure may increase depending on the essential job duties of the role.Are you ready to make a difference? Apply Today!Ochsner Health does not consider an individual an applicant until they have formally applied to the open position on this careers website.Individuals who reside in and will work from the following areas are not eligible for remote work position: Colorado, California, Hawaii, Maryland, New York, Washington, and Washington D.C.Ochsner Health endeavors to make our site accessible to all users.  If you would like to contact us regarding the accessibility of our website, or if you need an accommodation to complete the application process, please contact our HR Employee Solution Center at 504-842-4748 (select option 1) or careers@ochsner.org. This contact information is for accommodation requests only and cannot be used to inquire about the status of applications.We are proud to be an Equal Employment Opportunity and Affirmative Action employer. We are committed to the principles of equal employment opportunity and providing a workplace that is free from discrimination based on race, color, creed, religion, pregnancy status, pregnancy-related conditions, national origin, ancestry, mental or physical disability, medical condition, age, veteran status, military status, citizenship status, marital status, familial status, sexual orientation, gender, gender identity or expression, genetic information, political affiliation, unemployment status, or any other characteristic protected under applicable federal, state or local law. These protections extend to applicants and all employment related decisions. View the EEO is the Law poster and its supplement, as well as the pay transparency policy for more information. Affirmative Action Policy StatementSummaryLocation: New Orleans - New Orleans Region - LouisianaType: Full time