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VP of Value Based Care Risk and Strategic Insight
Vice President of Value Based Care Risk and Strategic Insight
Value based care (VBC) is a pillar of both the five-year IU Health system strategy (2020-2025) and the ten-year enterprise (IU Health and Indiana University) strategy (2016-2026). The goal is to serve over 75% of IU Health attributed lives in some VBC or risk arrangement by the end of 2026. IU Health is actively developing and deploying the care and support models to optimize the risk arrangements it pursues. Current risk arrangements include IU Health Plans Medicare Advantage and commercial insurance products, the IU Health Employee Benefits Plan, IU Health’s Next Generation Accountable Care Organization (NGACO) planned to transition to the CMS Direct Contracting program in 2022, and multiple risk arrangements with third-party payers and employer groups throughout the state. Medicaid and Exchange/Marketplace risk as well as an expanded commercial and employer group portfolio will likewise be in scope. IU Health currently manages risk for approximately 160,000 Hoosiers or approximately 15% of IU Health attributed lives.
The Vice President, Value Based Care Risk and Strategic Insight will lead the actuary, underwriting, network contracting, healthcare economics and medical economics teams that support the IU Health Plans and IU Health’s risk-based programs outlined above. Overall the leader will assist in developing and reporting on the VBC clinical outcome and total cost of care measures that support IU Health’s strategy.
Specifically, this leader will lead the teams that develop the IU Health Plans’ Medicare Advantage annual bid, forecast how risk adjusting activities impact IU Health Plans’ Medicare Advantage and other VBC program revenue and underwrite and actuarially price fully-insured and self-insured lines of business (including the employee benefit plan that serves over 40,000 members). In addition, the leader will oversee the Plans’ reserving activities and support the various data/analytics teams who maintain the Milliman MedInsight database and from which regular and system-level strategic analyses around utilization, trends and healthcare efficiencies are conducted. The leader will also support the teams who report on existing VBC programs and model future opportunities related to CMS advanced payment models and third-party payer arrangements. The leader will lead internal risk allocation discussions and recommendations. All activities will be in close coordination with leaders from the system and SHS finance (including the System CFO), accounting, revenue cycle and other areas.
Time: Full time
Updated: 11/16/2021 9:47:55 AM