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Resp & Qualifications
About CareFirst’s Practice and Payment Transformation Initiative:
CareFirst launched its first Value-Based Payment Arrangement, the Patient Centered Medical Home (PCMH) Program in 2011 and currently has more than 4,000 participating primary care providers organized into over 400 Panels. With 8 full performance years complete, the Program has produced savings (actual cost vs. expected cost) every year.
Building on the foundation of its PCMH Program, in 2019 CareFirst is creating new pay-for-performance, episode and population-based models to drive targeted improvements in the health care delivery system, specifically focusing on cost, quality and the CareFirst Member experience.
This senior-level expert contributor role exists to study, develop, execute and monitor and continuously improve new models to finance health care for CareFirst Members. Those serving in this role will drive CareFirst’s effort to transition from a fee-for-service payment system which incents health care providers to generate volume to a payment approach that rewards providers for the value they create.
The Value-Based Model Expert will be part of CareFirst’s Payment and Practice Transformation team. The Payment Transformation Initiative consists of an internal team of experts focused on innovative and impactful payment models (this role), specialty practice benchmarking and operations, clinical support, legal support, pharmacy support and government program practice readiness.
The impact of this team of internal experts is informed and magnified by a team of geographically dispersed Practice Transformation Consultants who work directly with Primary Care and Specialty Care Practices to improve their performance on key cost, quality and patient experience measures.
The Value-Based Model Experts will collaborate with the stakeholders across the organization to effectively monitor, evaluate, coordinate and communicate the overall effectiveness of the value-based payment models.
Under the general supervision of a Manager, Payment Transformation, the incumbent’s accountabilities may include, but are not limited to, the following:
1. Research, Market Awareness and Benchmarking
2. Creation, Approval and Implementation of New Models to Finance Health Care
3. Tracking/Monitoring and Reporting of Impact
The incumbent will not have direct supervisory responsibility but is heavily involved in the leadership and development of the Practice Transformation team as it relates to the implementation and monitoring of value-based models.
Department: Value Based Contracting
Equal Employment Opportunity
CareFirst BlueCross BlueShield is an Equal Opportunity (EEO) employer. It is the policy of the Company to provide equal employment opportunities to all qualified applicants without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, age, protected veteran or disabled status, or genetic information.
Hire Range Disclaimer
Actual salary will be based on relevant job experience and work history.
Where To Apply
Please visit our website to apply: www.carefirst.com/careers
Federal Disc/Physical Demand
Note: The incumbent is required to immediately disclose any debarment, exclusion, or other event that makes him/her ineligible to perform work directly or indirectly on Federal health care programs.
The associate is primarily seated while performing the duties of the position. Occasional walking or standing is required. The hands are regularly used to write, type, key and handle or feel small controls and objects. The associate must frequently talk and hear. Weights up to 25 pounds are occasionally lifted.
Sponsorship in US
Must be eligible to work in the U.S. without Sponsorship