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Leader, Regional VBP Account Management

MVP Health Care Rochester, NY
  • Posted: over a month ago
  • Other
Apply Now Leader, Regional VBP Account Management
Rochester Office, Rochester, New York, United States of America, Tarrytown Office, Tarrytown, New York, United States of America Req #229
Monday, August 5, 2019
Be a part of the transformation at MVP Health Care®. MVP Health Care is a nationally-recognized, regional not-for-profit health insurer. We care for more than 700,000 members across New York and Vermont and are powered by the ideas and energy of more than 1,700 employees. We employ talented people  with diverse backgrounds and experience—tech people, numbers people, even people people—to make health insurance more convenient, more supportive, and more personal. If you’re ready to join a thriving, mission-driven company where you can create your own opportunities—it’s time to make a healthy career move to MVP.

Status: Full-time, Exempt: Yes

Leader, Regional VBP Account

Status: Full-time, Leader IV

Position Summary

for Provider Partner business development, strategic account management, negotiating
VBP and alternate payment model contracts in the region and implementing
strategic account plans for key provider relationships representing a significant
proportion of MVP’s membership and clinical expenditures.  Works with Network leadership, team members,
key leaders/contributors across the organization, as well as key leaders/contributors
from outside MVP to develop, negotiate, implement, oversee and evaluate value-based
contract models and alternate payment models for the region, including: Shared Savings
and Risk Models, Capitation, Global Payments, Bundles, Incentive Plans and
other non FFS reimbursement models. Develop an understanding of the needs and
goals of our participating providers as they transition into VBP, including social
determinants of health and Integrated Behavioral Health models, and support as
they successfully take on increasing levels of risk.  The role involves coordinating senior level interdisciplinary
teams within MVP to solve complicated problems related to targeted
interventions designed to achieve the Triple Aim in collaboration with our
provider partners.  Represents MVP on
regional collaboratives and leads internal and external meetings with senior
leaders, business partners for the development and management of long-term Provider
Relationships and VBP Arrangements.  The
position is expected to be an active participant in Payment Reform activities
and to support the design, implementation and program management and evaluation
of the value-based contracts and programs in the region. Produces strategic
account plans to support provider engagement, as well as program
implementation, monitoring and evaluation. Ensures the establishment and
tracking of contracting and financial and quality settlements, as well as coordinates
other key milestones and deliverables. Oversees the provision and analysis of
scheduled, as well as ad hoc, data requests, information and reports. Supports
the response to VBP, Advanced Primary Care, regulatory or government surveys as
needed. The Leader is responsible for hiring, supervision and training of Population
Health Manager. In addition to these primary responsibilities, the Leader will
perform other duties as assigned in fulfillment of MVP’s broader VBP and Network
Strategy goals.

Position Qualifications:

Minimum Education:

BA/BS in business, health care administration or related field preferred.

Equivalent amount of education and related experience considered.

Minimum Experience:

Five years of health plan or provider experience

Five years of increasing responsibilities in working with providers and provider
organizations Minimum of two years’ provider contracting and negotiating experience

Two years’ experience managing team members and programs. 

Preferred Experience:

Minimum of three years of increasing experience in the Value Based Care programs or Population Health, including direct contracting experience

Experience with social determinants of health and community-based organizations is a plus, as is experience with Integrated Behavioral Health models.  

Required Skills: 

  • Detail-oriented worker with excellent organizational skills, able to work on multiple projects simultaneously and meet deadlines.

  • Strong presentation, written and public speaking skills

  • Excellent leadership and training skills

  • Contracting and negotiating experience

  • Business development and strategic account management

  • Strong financial background, ability to analyze financial data required

  • Ability to effectively evaluate health care data

  • Strength in problem solving based on experience, subject matter expertise, and objective data analysis

  • Ability to effectively use Microsoft Office software

  • (Excel, PowerPoint, Microsoft Project, Access, Visio and Word).

  • Ability to travel as needed required 

Preferred Skills: 

  • Knowledge of clinical workflows and/or clinical experience is a plus but not required

  • Knowledge of administrative datasets (i.e. claims, eligibility etc.) reporting /analytic
    uses (e.g. cost and utilization reporting, disease management, quality measurement
    etc.) and terminology (e.g. PMPM, and per 1000 measures, HEDIS and NQF quality
    measurement, diagnosis/procedure codes, episode groupers, risk adjustment,
    Project Management experience #ZIP

MVP Health Care is an Affirmative Action/Equal Opportunity Employer (PDF). We recruit, employ, train, compensate, and promote without regard to race, religion, creed, color, national origin, age, gender, sexual orientation, marital status, disability, genetic information, veteran status, or any other basis, e.g., Pay Transparency (PDF), protected by applicable federal, state or local law. Any person with a disability needing special accommodations to the application process, please contact Human Resources at

Other details
  • Job Family Network Management & Development
  • Pay Type Salary

MVP Health Care

Why Work Here?

Love your job - Get the flexibility you need - Be rewarded for hard work

What's it like to work at MVP? MVP is a nationally recognized, award-winning leader for a reason. The beating heart of our company is a wide range of employees from a diverse set of backgrounds—tech people, numbers people, even people people—working together to make health insurance better. If you’re ready to join a thriving, mission-driven company where you can create your own opportunities—it’s time to make a healthy career move to MVP.

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