Job Description

Employment Type

Full-time

Exempt or Non-Exempt

Exempt

Job Summary

**Hybrid Work Environment - Must reside in Oahu** * Directs and oversees HMSA\'s provider contracting for value-based programs.

• Design, develop and operationalize new clinical integration programs.
• Design, develop and operationalize next-generation payment models.
• Relationship manager for key partner providers in market.

• Bachelor\'s degree and three years of related work experience; or an equivalent combination of education and related work experience.
• One year of supervisory or management experience.
• Excellent written and verbal communication skills (with distinction in driving discussions with senior executives internally to HMSA and across partner organizations and community leaders.)
• Knowledge of health care payment and delivery models and systems; understanding of health plan role and industry.
• Strategic planning and contracting or health care administration/finance experience.
• Must have valid driver\'s license, access to an automobile with current license, registration, and no-fault insurance.

• Design, develop and operationalize new clinical integration programs for key partners in market. Will act as primary program lead for value-based deals and special provider projects.
• Design, develop and operationalize next-generation payment models for key partners in market. Will collaborative build next-gen models with key ACOs leaders / PO leaders and high-value physicians in market.
• Act as chief negotiator, contract manager and relationship manager for all value-based partnerships in market. Will be lead for ensuring that program goals / terms are aligned with contract constructs.
• Act as the primary relationship manager for key partners in market and provide on-going BAU support to key provider partners. Sr Contracting Manager will

• Be the primary business lead for all BAU processes associated with VB programs.
• Lead provider meetings
• Lead the process to build clinical pathways with provider partners.
• Lead payment integrity & attribution integrity processes for all VB programs.
• Lead design and operations for BAU/ad-hoc/executive reporting for all VB programs.
• Ensure that all of the above will be coordinated with targeted provider partners.
• Act as internal program manager for all value-based projects. Sr. Contracting Manager will

• Lead matrixed staff compliment -- comprised but not limited to program office (medicare/medQuest), legal, clinical operations, analytics-IT, finance staff.
• Ensure that all internal divisions are apprised on status of all VB programs.
• Lead all internal meetings with matrixed team members.
• Perform all other miscellaneous responsibilities and duties as assigned or directed.

Hawaii Medical Service Association