Director Payment Innovation and Analysis-SWHR CIN at Southwestern Health Resources CIN in Pittston, Pennsylvania

Job Description:

Please note: Southwestern Health Resources Clinically Integrated Network (SWHR CIN) is an affiliated company of Texas Health and UT Southwestern. If hired for this position, you will become a SWHR CIN employee rather than a Texas Health or UT Southwestern employee.

Southwestern Health Resources Clinically Integrated Network (SWHR CIN), is hiring for a Director Payment Innovation and Analysis.

This position supports the VP Healthcare Economics by directing the daily activities of physician managed care rate analysis, value-based payment design & analysis, and physician revenue performance reporting. The position will direct the activities of 2-3 supporting analysts and present findings and recommendations to leadership for consideration.

Salary range is Min. $102,960/year to Max. $159,057/year - based on relevant experience

Location: After our Covid protocol ends, this will office in Farmers Branch

Work Schedule

• Full time, day shift

Job Description

Direct the activities of the physician analytics to staff in support of professional managed care & market relations FFS contracting activities on behalf of Texas Health Physicians Group (THPG), UT Southwestern (UTSW) Faculty, and UTSCAPs. Design processes that utilize sources and methods in a way that ensures results are correct. Coordinate results and present analyses and recommendations to the executive staff for consideration.

Direct staff activities related to warehousing of fee schedules and utilization sets for THPG, UTSW Faculty, and utilization models for UTSCAPs. Direct the process of regular professional utilization trend reporting and insight mining. Direct the contract rate implementation process with all physicians described above.

Design value-based analyses that leverage health related claim data for purposes of evaluating proposed and resulting savings from the total cost of care arrangements including those with healthplans, bundles, and employers. Support leadership in designing and tracking key performance indicators related to these arrangements.

Direct the team on researching existing and emerging professional reimbursement methodologies in support of CIN, THPG & UTSW Faculty operations decisions (i.e. telemedicine, MACRA, & BPCI.)
Recruit, train, and retain capable physician revenue and pricing analysis staff. Ensure that stakeholders (UTSW Faculty, THPG, CAPs, and CIN) get reliable results in a timely manner.

The ideal candidate will possess the following qualifications

Education
Bachelor's Degree in Business or related field required
Master's Degree preferred

Experience
5 years progressive revenue finance and management including managed care analysis and value-based payment design is required

Skills
Must possess the insight and tact to work across both THR/THPG & UTSW to engage others to provide the support and information that are essential in critical decision making.