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Executive Director, Private Market Innovations

Position:                                  Executive Director, Private Market Innovations

Department:                                        Clinical Affairs

Employee in Position:            * * * * VACANT * * * *

Reports to:                              SVP, Private Market Innovations & Quality Initiatives

Scope:                                     Fulltime; Exempt; Professional

Date:                                       February 2019

 Position Summary:

Working under the general direction of Senior Vice President, Private Market Innovations & Quality Initiatives, the Executive Director, Private Market Innovations is responsible for leading efforts in the Clinical Affairs to assess market trends, educate members, develop policy and respond to regulatory and legislative proposals in the areas of health plan accreditation standards, health plan payment to providers,  innovations in healthcare delivery models, and healthcare data and interoperability. This position will also represent the organization at external meetings and be responsible for communicating the industry’s position and advancing industry interests.

Specific Responsibilities:

  •   Maintain  tracking system of key market trends and catalogue best practices pertaining to value-based care and payment.
  • Prepare member educational materials such as issue briefs, memos and newsletter articles health plan accreditation standards, health plan payment to providers, innovations in healthcare delivery models, and healthcare data and interoperability.
  • Track, prioritize, analyze implications, sequence activities, solicit member feedback, and lead comment responses to proposed regulations or requests for information issued by CMS and other federal agencies as well as draft legislation by Congress or state legislative bodies that pertain to payment and delivery system reform.
  • Support development of comment responses on health plan standards from key organizations such as NCQA and URAC.
  • Interact with external organizations in a variety of ways: one-on-one conference calls, represent the industry in multi-stakeholder meetings on a variety of topics, and present at meetings.  Communicate effectively industry position and value on these topics.
  • Support the Integrated Delivery Network Workgroup by recruiting speakers, preparing materials for member calls and meetings, developing and articulating consensus on issues and ensuring member engagement.
  • Support the Health Information Technology & Interoperability Workgroup by recruiting speakers, preparing materials for member calls and meetings, developing and articulating consensus on issues and ensuring member engagement.
  • Serve as expert on the identified issues acting as a resource to internal and external partners including responding to member and intra-divisional inquiries.
  • Support interdepartmental priorities by providing content and talking points for time sensitive press inquiries, policy statements on federal and state proposals, testimonies, etc.
  • Develop and foster relationships with key contacts at member health insurance plans and external coalitions/workgroups to communicate member interests and identify opportunities for additional collaborations on initiatives of strategic interest to the AHIP membership.
  • Other tasks and duties as assigned.

    Skills and Expertise:

  • Significant knowledge of health plan operations, provider contracting and alternative payment model design
  • Knowledge of healthcare information interoperability and public healthcare programs
  • Experience interpreting / summarizing / developing health policy at the Federal or State level
  • Excellent analytical, oral and written communication skills
  • Ability to work with diverse stakeholders and think strategically
  • General understanding of financing and delivery of care in the U.S.
  • Experience driving consensus across stakeholders
  • Strong time and project management skills to meet ongoing deadlines
  • Proficiency with Microsoft Office applications; specifically, MS Word, PowerPoint and Excel.

Education:

  • Minimum of Master of Public Health, Health Services Administration, Business Administration or related

Experience:

  • Minimum of 7 years of experience in health care and/or health plan operations, health policy or federal programs.
  • Experience working with health insurance plans, federal or state agencies, and key external partners on issues of strategic interest.
  • Experience developing, commenting on and responding to health-related regulations and legislation.
  • Experienced writing comment letters, testimony, advocacy materials and consumer-facing materials.
  • Experienced presenting to large multi-stakeholder groups on complex health industry issues.
  • Experience working in a collaborative environment.
  • Strong knowledge of regulations affecting both payers and providers.

Certifications:

  • None

Physical Work Activities & Conditions:

  • Continuous sitting for prolonged periods more than 4 consecutive hours in an 8-hour day.
  • Keyboard use of greater or equal to 65% of the workday.

Percent of Travel:

            Up to 10%.

The purpose of a job description is to describe the overall function and general responsibilities of a job. Job descriptions are used in hiring and training and to provide employees with a better understanding of employer expectations. Actual job functions and duties will vary as job responsibilities and business needs require.

Equal Opportunity Employer

America’s Health Insurance Plans (AHIP) is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, age, disability, religion, sex, sexual orientation, gender identity, national origin, or status as a protected veteran.

Interested candidates are requested to visit AHIP’s Career Website: https://www.ahip.org/about-us/careers-at-ahip/  for further instructions on resume submission.

How to Apply

Equal Opportunity Employer M/F/D/V

AHIP is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, age, disability, religion, sex, sexual orientation, gender identity, national origin, or status as a protected veteran.

AHIP does not sponsor applications for work visas.

In order to request consideration for an opened position at AHIP, all candidates must complete an AHIP Job Application and submit it, along with a current resume and cover letter that includes your requested salary range. We also ask that you complete and return the three voluntary forms that aid us in our attempt to meet our affirmative action goals:

All voluntary documents will be used for Affirmative Action tracking purposes only, and will be held confidentially in our Human Resources Department. They will not be viewed during the hiring process.

Once completed, all forms should be returned to our recruitment mail box at: hr@ahip.org or mail to:

America’s Health Insurance Plans (AHIP)
ATTN: HR Dept/CAEDPMI
601 Pennsylvania Avenue, NW
South Building, Suite 500
Washington, DC 20004