DIRECTOR OF CLINICAL, FINANCIAL, AND PAYMENT MODEL IMPLEMENTATION
MARYLAND HEALTH SERVICES COST REVIEW COMMISSION
MANAGEMENT SERVICE
LOCATION: 4160 Patterson Avenue
Baltimore, Maryland 21215
NATURE OF WORK: The Maryland Health Services Cost Review Commission seeks a senior level Director to provide management, oversight, and advice regarding hospital clinical and financial data analysis and payment model implementation. The HSCRC is responsible for developing, refining, and implementing Commission policy geared toward achieving its mandate of providing maximum efficiency and effectiveness at Maryland hospitals and achieving the goals of the Maryland All-Payer model approved by the Centers for Medicare and Medicaid Services (CMS). This position requires strong quantitative, analytical, negotiation, leadership, management, and decision-making skills. The Commission is an independent agency of Maryland government and is unique in the U.S. because it sets hospital rates for self-pay and commercial patients as well as for Medicaid and Medicare patients as a result of its waiver from Medicare’s Prospective Payment System.
This position will primarily be responsible for:
- Helping to lead the effort to transform the Maryland health care system in compliance with the All-Payer Model Agreement with the Centers for Medicare and Medicaid Services;
- Coordinating with and reporting to the federal government (CMS, CMMI, OMB) relative to their monitoring and auditing of requirements and metrics pursuant to a modernized waiver authority;
- With the Executive Director, overseeing modernized waiver activities, including developing a mechanism to track Maryland’s performance on any new waiver requirements under waiver modernization;
- Coordinating with state (DHMH, MHCC, and others) and local agencies regarding innovation projects and grants where there is a nexus with the Commission's population-based payments strategies;
- Advising on health care reform related activities for the Commission including analyzing, evaluating, monitoring and implementing population-based hospital payment structures and incentives;
-Assist in developing new analytic models and in leading the analytics implementation for Total Cost of Care;
- Working with the Executive Director to negotiate innovative population-based payment strategies with individual hospitals, and writing and executing such agreements;
- Working with the Executive Director, in responding to audits, investigations, press and public inquiries regarding the Commission's new payment policies;
- Making recommendations to the Commission;
- Drafting and leading related procurement activities;
- Leading, scheduling and organizing policy development processes; and
- Implementing new methodologies and payment-related initiatives.
The position provides an extraordinary opportunity for a highly motivated individual interested in promoting equity and efficiency, cost containment, improved access, and improved quality of care at hospitals in Maryland. Under the All-Payer system, Maryland is capable of implementing many aspects of the Affordable Care Act, such as value-based purchasing, and meeting the three-part aim on an all payer basis. The Commission has a robust hospital data set, which allows for refined risk-adjustment; relative metrics of efficiency, effectiveness and quality; and financial and billing accountability.
MINIMUM QUALIFICATION REQUIREMENTS:
Master’s degree in Health Care Policy, Public Policy, Economics, Health Services Administration or Research, Finance, or a closely related field with five years of experience involving analytical and quantitative work in health policy development and analysis, health economics, or health care financing. Experience in the successful direction of a health-related professional staff is desirable.
A Ph.D. can substitute for 2 years of experience.
Ten years of experience in the above fields and managed care finance may substitute for the education requirements.
SUCCESSFUL CANDIDATE WILL DEMONSTRATE: Strong leadership, negotiating, analytical and quantitative capabilities to actively oversee and direct the functions of the Commission, as well as the ability to communicate effectively and interact with Commissioners, industry representatives, policy makers, and the public. Strong writing and public speaking capabilities are essential. A working knowledge of per capita costs and payment models is desirable.
SALARY: Negotiable
FRINGE BENEFITS: Excellent State Benefits/Leave Package
HOW TO APPLY: Please apply online. Applicants must complete the online application at JobAps (www.jobaps.com/md/jobs/dhmh) and attach resume and cover letter by no later than April 22, 2016.
Direct link to position: http://www.jobaps.com/MD/sup/bulpreview.asp?R1=16&R2=009246&R3=0001