America’s Health Insurance Plans (AHIP)

Job Description

Job Title: Executive Director, Delivery System and Payment Transformation

Classification: Exempt

Compensation: Salaried

Reports to: SVP, Private Market Innovations & Quality Initiatives

Date: September 2020

 

JOB DESCRIPTION

Summary/Objective

Working under the general direction of Senior Vice President, Private Market Innovations & Quality Initiatives, the Executive Director, Delivery System and Payment Transformation is responsible for assessing market trends, educating members, developing policy and responding to regulatory and legislative proposals in the areas of health plan accreditation standards, fee-for-service payments to providers, innovations in healthcare delivery and payment models, healthcare data and interoperability, and other issues as they arise. This position will also participate in external meetings on behalf of the organization and be responsible for communicating the industry’s positions and advancing industry interests.

Essential Functions

Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

1. Maintain tracking system of key market trends and catalogue trends and best practices pertaining to value-based care and payment. 

2. Prepare member written educational materials including regulatory summaries, issue briefs, slides, member memos and newsletter articles.

3. Track, prioritize, analyze implications, sequence activities, develop policy, 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.

4. Support development of comment responses on health plan standards from key organizations such as NCQA and URAC.

5. Communicate industry positions effectively through interactions with external organizations in a variety of ways: one-on-one conference calls, multi-stakeholder meetings, and presentations.   

6. Develop and foster relationships with key contacts at member health insurance plans and other associations to advance member interests and identify opportunities for additional collaborations on initiatives of strategic interest to the AHIP membership.

7. Support Clinical Innovations workgroups including but not limited to Value-based Care, Health Information Technology, and Coding by recruiting speakers, preparing materials for member calls and meetings, developing interactive collaborative initiatives, and articulating consensus on issues and ensuring member engagement.

8. Serve as subject matter expert on the identified issues acting as a resource to internal and external partners including responding to member and intra-divisional inquiries.

9. Support interdepartmental priorities by providing content for time sensitive press inquiries, policy statements on federal and state proposals, testimonies, et

10. Other tasks and duties as assigned. 

Supervisory Responsibility

This position has no supervisory responsibilities.

Required Education and Experience

1. Master of Public Health, Health Services Administration, Public Policy, Business Administration or related field preferred and/or equivalent experience.

2. Seven years or more of experience in health care and/or health plan operations, health policy or federal programs preferred.

3. Experience working with health insurance plans, federal or state agencies, and key external partners on issues of strategic interest.

4. Experience analyzing and developing policy on health-related regulations and legislation.

5. Experience writing comment letters, testimony, white papers, newsletters, advocacy materials and consumer-facing materials.

6. Experience presenting to large multi-stakeholder groups on complex health industry issues.

7. Experience working in a collaborative environment. 

8. Strong knowledge of regulations affecting both payers and providers.

Competencies

1. Significant knowledge of health plan operations, provider contracting and alternative payment model design

2. Familiarity with provider and/or plan quality measurement

3. Knowledge of healthcare information interoperability and public healthcare programs

4. Experience interpreting / summarizing / developing health policy at the Federal or State level

5. Excellent analytical, oral and written communication skills

6. Ability to work with diverse stakeholders and think strategically

7. General understanding of financing and delivery of care in the U.S.

8. Experience driving consensus across stakeholders

9. Strong time and project management skills to meet ongoing deadlines

10. Proficiency with Microsoft Office applications; specifically, MS Word, PowerPoint and Excel.

Work Environment

This job operates in a professional office environment. This role routinely uses standard office equipment.

Physical Demands

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job.

While performing the duties of this job, the employee is regularly required to talk or hear. The employee frequently is required to stand; walk; use hands to finger, handle or feel; and reach with hands and arms. Specific vision abilities required by this job include close vision, distance vision, color vision, peripheral vision, depth perception and ability to adjust focus.

Position Type/Expected Hours of Work

This is a full-time position.  Standard days and hours of work are Monday through Friday, 8:30 a.m. – 5:30 p.m., however may require long hours and weekend work.

Travel

Up to 10%.

Disability Specifications

AHIP will make reasonable accommodations in compliance with the Americans with Disabilities Act of 1990.

AHIP is an Equal Opportunity/Affirmative Action Employer.

Other Duties

Please note this job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee for this job. Duties, responsibilities and activities may change at any time with or without notice.

To Apply: 

Candidates can submit their resume and cover letter to  hr@ahip.org.