Senior Director Payment Innovation

At Cleveland Clinic Health System, we believe in a better future for healthcare. And each of us is responsible for honoring our commitment to excellence, pushing the boundaries and transforming the patient experience, every day.

We all have the power to help, heal and change lives - beginning with our own. That's the power of the Cleveland Clinic Health System team, and The Power of Every One.

Job Title

Senior Director Payment Innovation

Location

Cleveland

Facility

Cleveland Clinic Main Campus

Department

Managed Care-Finance

Job Code

T98841

Shift

Days

Schedule

8:00am-5:00pm

Job Summary

Join the Cleveland Clinic team, where you will work alongside passionate caregivers and provide patient-first healthcare. Cleveland Clinic is recognized as the No. 4 hospital in the nation, according to the U.S. News and World Report. At Cleveland Clinic, you will work alongside passionate and dedicated caregivers, receive endless support and appreciation, and build a rewarding career with one of the most respected healthcare organizations in the world.

As the Senior Director Payment Innovation, you will serve as the key finance leader responsible for overseeing the development, implementation and ongoing financial performance monitoring of new value based financial vehicles and/or programs (e.g., MSSP, CMS BPCI, commercial bundles). You will also serve as key finance liaison with the offices of strategy, clinical transformation, the quality alliance and the department of Market and Network Services in the deployment of financial vehicles such as alternative payment models, population health risk products and associated platforms.

Cleveland Clinic provides what matters most: career growth, delivering world-class care to our patients, continuous learning, exceptional benefits and working for an organization that offers many long-term career paths. Join us and experience a culture where opportunities to advance and the support to get there go hand-in-hand.

Job Details

Responsibilities:

• Leads and partners in the design, implementation and ongoing monitoring of value based financial vehicles, partnerships and programs.
• Leads the effort to explore and pilot innovative financial vehicles to capture value for CC.
• Engages with clinical leadership to understand clinical care innovation and value creation.
• Partners in efforts to develop the capabilities required for CC to successfully take on financial risk.
• Leads the development of an industry leading, highly innovative team recognized for thought-leadership, strong partnerships and leading edge practices.
• Partners in contract/network design and negotiation.
• Partners in setting cost and utilization targets.
• Monitors financial performance and identify cost and utilization opportunity.
• Develops processes to support Finance in a production mode to ensure program success and compliance.
• Serves as key liaison to external parties related to financial vehicle design, implementation and performance monitoring (e.g., CMS, commercial payer committees, State of Ohio).
• Actively researches financial and reimbursement innovation.
• Serves as key finance participant on relevant committees such as GoTo Market, Contracting, Population Health and Specialty Care.
• Works to advance Finance objectives on behalf of the Cleveland Clinic Health System.
• Interfaces with all levels of management, both internal and external to the Cleveland Clinic Health System.
• Other duties as assigned.

Education:

• Bachelor's Degree in business, marketing or health care related field.
• Master's Degree preferred.
• Working knowledge of contemporary managed care policy practices and reimbursement methodologies.

Certifications:

• None Required.

Complexity of Work:

• Within the scope of the job, requires critical thinking skills, decisive judgment and the ability to work with minimal supervision.
• Must be able to work in a stressful environment.

Work Experience:

• A minimum of 10 years of managed care or healthcare P&L management experience in a payor or provider setting.
• Strong familiarity with key contract items, legal issues and contract analysis.
• A Master's degree may offset 2 years of experience.

Physical Requirements:

• Manual dexterity to operate office equipment.
• May require extended periods of standing, walking or sitting.
• Good visual acuity through normal or corrected vision.

Personal Protective Equipment:

• Follows Standard Precautions using personal protective equipment as required for procedures.

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Keywords: Payment Innovation, Bundled payments, Government programs, managed care, alternative payment models

The policy of Cleveland Clinic Health System and its system hospitals (Cleveland Clinic Health System) is to provide equal opportunity to all of our employees and applicants for employment in our tobacco free and drug free environment. All offers of employment are followed by testing for controlled substance and nicotine. Job offers will be rescinded for candidates for employment who test positive for nicotine. Candidates for employment who are impacted by Cleveland Clinic Health System's Smoking Policy will be permitted to reapply for open positions after 90 days.

Cleveland Clinic Health System administers an influenza prevention program as well as a COVID-19 vaccine program. You will be required to comply with both programs, which will include obtaining an influenza vaccination on an annual basis, and being fully vaccinated against COVID-19, or obtaining an approved exemption.

Decisions concerning employment, transfers and promotions are made upon the basis of the best qualified candidate without regard to color, race, religion, national origin, age, sex, sexual orientation, marital status, ancestry, status as a disabled or Vietnam era veteran or any other characteristic protected by law. Information provided on this application may be shared with any Cleveland Clinic Health System facility.

Please review the Equal Employment Opportunity poster.

Cleveland Clinic Health System is pleased to be an equal employment employer: Women / Minorities / Veterans / Individuals with Disabilities