Vice President, Medicare Strategy -CMMI
Company: Providence Health & Services
Posted on: June 6, 2021
This position has overall accountability for development and
implementation of Medicare VBC strategy and related program
management across Providence Health & Services. By partnering with
regional and system leaders, this role will identify key regulatory
opportunities for growth and operational performance and will lead
development of specific recommendations and tactics to address the
opportunities. This role will develop a proactive relationship with
internal advocacy teams, and policy leaders in government and
industry to position Providence as an industry leader in improving
outcomes for their patient populations. The VP of Medicare Strategy
will develop a multi-year roadmap for this program. This role will
also be responsible for building and mentoring the Medicare VBC
team, consisting of Program Leaders and analysts who manage and
administer Medicare value based reimbursement programs across the
The Vice President, Medicare Strategy will have the following
- Team Development and Executive Leadership
- Project executive presence and represent PSJH's thought
leadership position in value based care programs as part of senior
leadership interactions internally and with industry peers.
- Build consensus on Medicare Strategy across system and regional
- Lead a geographically distributed team of Program Leaders and
- Set clear goals and performance expectations, function as a
coach and mentor the team to lead in a matrixed organization
- Lead staff development processes including career progression
Develop collaborative operating mechanisms that ensure alignment
with other departments and teams internally within Population
Health and with the rest of shared services and the system such as
regional leadership teams, Physician Enterprise, Information
Services, Healthcare Intelligence, and Clinical Analytics.
- Serve as a domain expert on Regulatory provisions and related
changes in Value Based payment policy:
- Create and lead methodical approach to monitoring external
environment, developing summaries and implications and sharing
findings across Providence and affiliates.
- Develop and maintain in-depth knowledge of Medicare programs'
requirements and needs, market solutions and competitor
- Serve as key business contact for Government affairs team and
lead evaluations / analysis to understand business implications of
any proposed policy changes.
- Understand regulatory framework and implications for business
strategy and operations.
Develop and nurture industry relationships to understand
regional and national trends and solutions and incorporate into
- Develop Medicare Strategy:
- Executive responsible for developing system wide strategy and
roadmap for Medicare programs. Focus areas include: MSSP, MACRA,
MU/ACI, CPC and other value-based programs initiated by CMS.
- Engage leaders from Physicians services, payer contracting,
ACOs, Operations, marketing, clinical institutes, innovation,
finance, regional teams, and shared services as required to develop
and finalize strategy.
- Working with Regional Chief Executives, develop market specific
strategies to achieve overall system strategy and growth
Develop metrics and other success measures and monitor
- Build Strategic Partnerships:
- Identify and build potential partnerships with external
organizations such as payers that support overall strategy.
- Serve as key executive in developing and nurturing
relationships to develop alignment.
Partner with Contracting, Legal and other departments to ensure
proportional contractual obligations in risk based arrangements
- Implementation & Operations:
- Lead development of implementation plans.
- Lead and/or coordinate execution of implementation plans.
- Identify and resolve any issues that arise during
- Provide ongoing leadership and consultation for regional
operations to ensure achievement of regional and system
Required experience/education for this position include:
- Master's degree in Business Administration, Health Sciences, or
other relevant discipline
- Ten years of progressively increasing responsibility in managed
care/ health economics as part of a payer or healthcare delivery
- Expertise in Medicare Payment reform policies and demonstrated
experience in implementing Medicare APMs such as MACRA/MIPS, CPC ,
PCF, MSSP, DC.
- Knowledge of CMS and ONC Health IT policy making and fluent in
policies related to adoption of Health IT interoperability
- Demonstrated experience in developing successful working
relationships with other organizations.
Preferred experience/education for this position include:
- Expertise in Population Health strategies and operational model
- Training and background in implementation of change management
initiatives at enterprise scale.
Keywords: Providence Health & Services, Renton , Vice President, Medicare Strategy -CMMI, Other , Renton, Washington
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