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Director, Medicare Advantage Value Based Reimbursement Programs in Columbia, SC

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compensation:

$200K - $250K*

specialty:

Accounting, Risk & Quantitative Analysis

experience:

8 - 10 years

Job Description

Establishes value-based reimbursement arrangements with Medicare Advantage providers. Assists with the development and execution of the Medicare Advantage provider network strategy, with a focus on Stars performance, responsiveness to plan clinical requests, and risk sharing arrangements. Develops and communicates a vision for an innovative and outcome-based Medicare Advantage network growth strategy, considering the evolving competitive marketplace and provider landscape.

Description

35% Drive the design of Medicare Advantage provider value based programs, including risk contracting and innovative value-based incentive programs, to maximize performance in Stars and drive accurate risk coding. Evaluate strategic positioning for value-based incentive and risk sharing programs within the designated market.

30% Design, implement, and manage value-based contracting performance tools / dashboards to track provider performa

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Valid through: 2020-4-9

About BlueCross BlueShield of South Carolina

BlueCross BlueShield of South Carolina (BCBSSC) is an independent licensee of the Blue Cross and Blue Shield Association. BCBSSC serves 21.5 million people through private business and government contracts. BCBSSC has several subsidiaries, two of which are affiliates licensed with the Blue Cross and Blue Shield Association. Licensed subsidiaries include BlueCross BlueShield of South Carolina Foundation and BlueChoice HealthPlan. Non-licensed affiliates include Companion Captive Insurance Company, Companion Life, PGBA, LLC, Planned Administrators, Inc. (PAI) and TCC of South Carolina. BCBSSC began as the South Carolina Hospital Service Plan, later becoming BlueCross of South Carolina (BlueCross), when the General Assembly passed legislation bringing this group into existence. In the spring of 1947, the South Carolina Hospital Service Plan merged with the Hospital Benefit Association of Greenville, giving them a financial base. In 1971, BlueShield of South Carolina merged with BlueCross to form the current company.
Total Jobs:
55
Total Experts:
16
Average Pay:
$122,717
Total value of jobs:
$16,935,000
% Masters:
43%

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* Ladders Estimates