at Elevance Health in CHICAGO, Illinois, United States
Job Description
Location: Open to anywhere within the continental US that is within 50 miles of an office Pulse Point location.
Elevance Health operates in a Hybrid Workforce Strategy, providing various levels of flexibility while also ensuring that associates have opportunities to connect in-person. Unless in a designated virtual-eligible role and specified as primarily virtual by the hiring manager, associates are required to work at an Elevance Health location several times a week. Specific requirements and expectations for time onsite will be discussed as part of the hiring process
Summary
The Staff VP of Payment Innovation will be responsible for the design, development, analysis and measurement of Carelon’s Specialty Provider Value-Based Care (VBC) Payment Models, including Total Cost Risk and Shared Savings, Episode Bundle Payments, and other Specialty Incentive programs. Accountable for program analytics, insights, tracking in collaboration with key stakeholders and product strategies.
Position Responsibilities
+ Lead insights, analytics, tracking and measurement of Carelon’s Specialty Provider Value-Based Care (VBC) programs.
+ Collaborate with Carelon Health leaders on the development of alternative payment models that support specialty clinical domains, including VBC penetration, downside risk growth, and performance across financial, quality, and health equity domains.
+ Partner with VPs, SVPs, and key stakeholders to address Provider VBC analytics.
+ Lead payment model methodology design efforts, including attribution, measure selection, target, and reconciliation. Model multiple scenarios when finalizing program design.
+ Identify technical capabilities required to implement payment innovation programs, and document requirements for the operational team to implement.
+ Collaborate with Carelon Health, IT, HE, and VBS resources to manage the completion of the payment model design, requirements, development, testing, and operational roll-out of a new or updated payment model.
+ Ensure all operational areas touching provider analytics are engaged in the development of required solutions, processes, workflows, job aids, training, and communication.
+ Partner with Carelon Health to ensure the smooth implementation and provider adoption of analytics, insights, and tracking capabilities.
+ Partner with Health Economics, VBS Operations, and Healthcare Networks (HCN)
+ Hiring, training, coaching, counseling, and evaluating the performance of direct reports.
Position Requirements
A bachelor’s degree and a minimum of 10 years of management experience in healthcare analytics, provider value-based measurement, and value-based program design; or any combination of education and experience, which would provide an equivalent background.
Ability to travel a minimum of 10-25%
Preferred Skills, Capabilities and Experiences
+ Advanced Degree preferred
+ Experience with reimbursement strategy and designing alternative payment models including Capitation, Total Cost Shared Savings/Risk, and Episode Bundle Payments
+ Experience with contract governance
For candidates working in person or remotely in the below locations, the salary* range for this specific position is $ 206,492 to $391,248.
Locations: California; Colorado; District of Columbia (Washington, DC), Hawaii; Jersey City, NJ; Nevada; New York; Washington State
In addition to your salary, Elevance Health offers benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). The salary offered for this specific position is based on a number of legitimate, non-discriminatory factors set by the company. The company is fully committed to ensuring equal pay opportunities for equal work regardless of gender, race, or any other category protected by federal, state, and local pay equity laws .
- The salary range is the range Elevance Health in good faith believes is the range of possible compensation for this role at the time of this posting. This range may be modified in the future and actual compensation may vary from posting based on geographic location, work experience, education and/or skill level. Even within the range, the actual compensation will vary depending on the above factors as well as market/business considerations. No amount is considered to be wages or compensation until such amount is earned, vested, and determinable under the terms and conditions of the applicable policies and plans. The amount and availability of any bonus, commission, benefits, or any other form of compensation and benefits that are allocable to a particular employee remains in the Company’s sole discretion unless and until paid and may be modified at the Company’s sole discretion, consistent with the law.
