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Value Based Program Consultant - Commercial Programs, Full-time, Days

Northwestern Medicine
City: 
Chicago
State: 
Illinois
Employment type: 
Full time
Required degree level: 
Other
Remote Position: 
No

Anchored by Northwestern Memorial Hospital, the No. 1 hospital in Illinois seven straight years by U.S. News & World Report , Northwestern Medicine's integrated health system is on a relentless pursuit of better healthcare. While each of our ten hospitals and over 300 clinic and administrative locations has a unique story, we all share the same vision: to serve Patients First.

Advance to a better career with Northwestern Medicine.

Why come work as a Consultant for Value Based Programs at Northwestern Medicine?

  • Anchored by Northwestern Memorial Hospital the No. 1 hospital in Illinois
  • Opportunities to improve the total health of patients and lower health costs
  • Ability to partner with some of the nation's leading physicians
  • In 2015, was named on 100 Best Companies for Working Mothers-16 th consecutive year
  • Leader in LGBTQ Healthcare Equality by the Human Rights Campaign
  • Competitive hourly pay
  • An employer that cares about growing your education with tuition reimbursement, professional development, and student loan repayment options.

The Consultant -Value Based Programs reflects the mission, vision, and values of NM, adheres to the organization's Code of Ethics and Corporate Compliance Program, and complies with all relevant policies, procedures, guidelines and all other regulatory and accreditation standards.

The Consultant -Value Based Programs will utilize analytic and basic project management skills to support the planning, implementation and daily operations of value-based and bundled payment model contracts and programs. Using robust analytics, critical thinking and innovative problem solving skills, the Consultant will evaluate program/contract opportunities and track performance. This individual must have a passion for learning and for working to improve health care and the patient experience at Northwestern Medicine.

Description

  • Demonstrates high proficiency in manipulating clinical and financial datasets and models in tools such as Excel, including use of Pivot Tables. Performs data analyses to identify program/contractual opportunities and trends. Supports the development of program-related data models in partnership with internal or vendor analytics collaborators as needed. Routinely monitors and reports on trends, and develop special reports as needed to further demonstrate drivers of trends that help inform mitigation strategies.
  • Manages relationships with external vendor partners and is expected to become a product or program subject matter expert.
  • Provide project support by ensuring project tasks are completed on-time, identifying next steps, communicating timely updates regarding project status, and proactively identifying potential risks and proposing solutions.
  • Supports day-to-day implementation of programmatic/contractual tasks and objectives.
  • Maintains strong understanding of relevant program/contract design and/or governmental policy implications within portfolio
  • Provides performance updates for initiatives and executive oversight. Analyzes and communicates key issues/trends and reports findings and recommendations to management.
  • Supports the development of executive level presentations that are related to initiatives.
  • Supports the team in assessing and administering payer contracts, provider network contracts for specific products and/or program participation agreements, including initial contracts, modifications and renewals. Helps to ensure organizational compliance with contracts.
  • Responsive to needs of internal and external stakeholders. Collaborates well with others and enjoys working as part of a team. Helps develop skills of new team members.
  • Desires to work in a fast-paced, dynamic environment and has ability to self-manage multiple projects and work streams.
  • Develops and maintains relationships between other key system function partners, including Contract and Payor Relations, Analytics, Finance, NMPN, and Quality, and Strategy. Works collaboratively with and supports multi-departmental efforts and projects.
  • Performs other activities as requested and prioritized by the Managers and Directors.
  • Demonstrates flexibility and organization while maintaining high levels of performance.
  • Adheres to strict guidelines for handling sensitive information in a confidential manner


Addendum :
Alternative Payment Product Development:
  • Supports the planning and management of our commercial payer value-based care contracts portfolio, including managed governmental payer-provider partnerships and emerging partnerships with employers and alternative aggregator of high performing provider networks.
  • Supports planning and execution of network adequacy for various products.
  • Maintains a foundational knowledge of health insurance payment models and products, including benefit design and the ability to effectively communicate and collaborate with others.
Required:
  • Bachelor's degree in Business Administration, Healthcare Management, Economics, Communications or related field.
  • 2-4 years of project-based experience in a professional field such as healthcare, insurance, finance, strategy or business development.
  • Foundational knowledge of healthcare financing, including reimbursement and emerging alternative payment models.
  • Strong passion for learning.
  • Skilled in use of Microsoft: Word, Excel, Power Point, Access, Project Clear, well developed oral and written communication skills.
  • Strong analytic skills, including familiarity with payer claims datasets.
Preferred:
  • Advanced degree in health management/policy or related field (i.e. MBA or MHA) preferred; required in place of work experience.
  • Previous work experience for a payer, provider organization or consulting firm with relevant portfolio responsibility in healthcare finance and reimbursement.

Northwestern Medicine is dedicated to providing the most advanced healthcare to the communities and patients we serve. The Northwestern Medicine clinical and administrative staff, medical and science faculty and medical students come together everyday with a shared commitment to superior quality, academic excellence, scientific discovery and patient safety.

Click the link find out more about Northwestern Medicine