Senior Director of Medical Cost Strategy
| Company | Homeward Health |
|---|---|
| Location | Austin, TX, USA, San Mateo, CA, USA, Chicago, IL, USA |
| Salary | $180000 – $250000 |
| Type | Full-Time |
| Degrees | |
| Experience Level | Senior |
Requirements
- 5+ years of hands-on cost of care management, including transitions of care, referral management, episodes of care, specialist subcapitation, pharmacy, behavioral health, and social determinants of health
- Demonstrated experience developing, implementing, and refining cost-of-care programs within a health plan or value-based care company
- Strong working knowledge of compliance, including audit experience and proficient knowledge of federal and state regulations
- Experience with provider engagement across internal, network, subcapitated, and other types of provider partners
- Experience in scaling clinical operations across unique markets, with a focus on outcomes, efficiency, and compliance
Responsibilities
- Build the foundation and playbook that drives cost improvement across our entire covered population, using a variety of available levers to influence both cost and outcomes
- Deep understanding of the cost levers available to Homeward, and a keen ability to think critically about how to partner with Payers and Providers to achieve cost objectives
- Partner with teams such as Analytics & Data Science, Platform & Technology, Clinical Operations and Strategy to translate complex clinical challenges into operational solutions
- Partner with Market Presidents, Provider Enablement, and Market Development teams to tailor and deploy solutions that are responsive to the local market dynamics and context, including solutions related to transitions of care, referral pathways, utilization management, high-value network development, and chronic condition management
- Lead or co-lead evaluation of external solutions that support the cost of care management, manage performance of those solutions, and drive evolution of our overall approach
- Leverage technology to drive cost reductions across multiple markets
Preferred Qualifications
- Experience in a high-growth, rapidly-scaling organization
- Experience with technology-enabled provider models
- Experience specifically with Medicare, Medicaid, and/or ACA lines of business