System Director Payment Transformation
Company: Dignity Health System Office
Location: Rancho Cordova
Posted on: May 5, 2022
CommonSpirit Health was formed by the alignment of Catholic Health
Initiatives (CHI) and Dignity Health. With more than 700 care sites
across the U.S. & from clinics and hospitals to home-based care and
virtual care services CommonSpirit is accessible to nearly one out
of every four U.S. residents. Our world needs compassion like never
before. Our communities need caring and our families need
protection. With our combined resources CommonSpirit is committed
to building healthy communities advocating for those who are poor
and vulnerable and innovating how and where healing can happen both
inside our hospitals and out in the community.
The System Director, Payment Transformation is accountable for data
analytics and financial performance analysis activities for
CommonSpirit Health's value-based agreements (VBA) and initiatives.
The Director develops and recommends strategies for maximizing
reimbursement and market share from value-based programs and
payment models. Designs and influences participation strategies
related to new value-based initiatives with payers that are
consistent with established strategic priorities. Provides VBA
program education to key stakeholders.
This role is a key member of the Population Health Insights
leadership team and contributes to the development and
implementation of system and local strategy, transformation to a
clinical enterprise, successful population health and physician
alignment strategies, and achievement of value-based growth
Essential Key Job Responsibilities
- Lead and manage the operations of the Payment Transformation
team including the orienting, developing, and managing a staff of
managers and analysts.
- Review and accurately interpret value-based program terms,
including development of policies and procedures in support of
value-based program participation.
- In conjunction with Payer Strategy & Relationships, perform
financial opportunity analysis for VBA contracts, spanning
commercial and government payers.
- Oversee the preparation of risk-share/gain-share funds flow
models and financial distribution reports of VBA payments and
repayments. Calculate expected and actual revenues/volumes,
population risk calculations, past performance, and impact of
proposed program terms and program/regulatory changes.
- Create complex financial performance analyses (involving
multiple variables and assumptions) to identify the
implications/ramifications/results of a wide variety of new/revised
VBA strategies, approaches, provisions, parameters and rate
structures aimed at establishing appropriate reimbursement
- Support Population Health initiatives and VBA Clinical Strategy
with data analyses, reports, dashboard development and maintenance,
and presentations as needed.
- Continued analytic support of performance and performance
opportunities throughout the duration of value-based
- Lead the identification, collection, and manipulation of data
from a wide variety of financial and clinical internal databases
and external sources (e.g., Medicare/Medicaid website, CMS SAF
files, etc.). Identify and access appropriate data resources to
support analyses and recommendations.
- Prepare and effectively present VBA analysis results to senior
leadership, Operations/Population Health leaders, and other key
stakeholders, for review and decision-making.
- Maintain knowledge of operations sufficient to identify
causative factors, deviations, allowances that may affect reporting
findings. Ability to translate operational knowledge to identify
unusual circumstances, trends, or activity and project the related
impact on a timely, pre-emptive basis.
- Take accountability for designated reimbursement and accounting
systems; be proficient in reading, interpreting, and formulating
complex computer system programming/rules.
- Bachelor's Degree in Business Administration, Accounting,
Finance, Healthcare or related field. - Master's degree
- Minimum of eight (8) years' experience in large healthcare
organizations and/or integrated healthcare delivery systems.
- Minimum of five (5) years' strategic leadership of healthcare
pricing, population health analytics, value-based agreement
negotiation, and/or healthcare economics in a complex, national or
multi-regional healthcare system or health insurance
- Advanced level knowledge of SQL and Excel.
- Advanced knowledge of value-based payment models, including
shared savings, bundled payments, pay-for-performance, and
- Strong background in financial healthcare/value-based
- Must be able to lead and coordinate projects through various
complex and challenging situations to completion under
- Ability to communicate effectively, both orally and written,
and provide formal reports, prepared for leadership at all
- Intermediate level knowledge and comfort with Google Suite
products a plus.
A compensation range of $123,000 - $160,000 is the reasonable
estimate that CommonSpirit in good faith believes it might pay for
this particular job based on the circumstances at the time of
posting. CommonSpirit may ultimately pay more or less than the
posted range as permitted by law.
While you're busy impacting the healthcare industry, we'll take
care of you with benefits that include health/dental/vision, FSA,
matching retirement plans, paid vacation, adoption assistance,
annual bonus eligibility and more
Keywords: Dignity Health System Office, Rancho Cordova , System Director Payment Transformation, Executive , Rancho Cordova, California
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