VP, Provider Contracting (Remote)
Homeward is a technology-enabled healthcare provider delivering quality, affordable and comprehensive care to those who don’t have it. Starting in rural America. Today, 60 million Americans living in rural communities are facing a crisis of access to care. In the U.S. healthcare system, rural Americans experience significantly poorer clinical outcomes. This trend is rapidly accelerating as rural hospitals close and physician shortages increase, exacerbating health disparities. In fact, Americans living in rural communities suffer a mortality rate 23 percent higher than those in urban communities, in part because of the lack of access to quality care.
Our vision is care that enables everyone to achieve their best health. So, we’re rearchitecting the way it’s delivered – leveraging breakthroughs in diagnostics, remote monitoring, and a variety of other domains, Homeward is creating a new healthcare delivery model that is purpose-built for rural America and directly addresses the issues that have historically limited access and quality.
Most importantly, we’re aligning everyone’s incentives (ours, partner health plans’, and members’) towards getting and keeping people healthy by taking full responsibility and financial risk for the total cost of each member’s healthcare and outcomes.
Homeward is co-founded by a leadership team that defined and delivered Livongo’s products, and backed most recently by a $50 million series B co-led by Arch Ventures and Human Capital, with participation from General Catalyst for a total of $70 million in funding. With this leadership team and funding, Homeward is committed to bringing high-quality healthcare to rural communities in need.
We seek a VP of Provider Contracting for this exciting opportunity to drive change and impact care delivery with provider partners. In this role, you will provide leadership, guidance, and oversight with respect to Value-Based Contracting with providers. You will oversee all provider network functions, including provider service, strategic relationships, and the value-based contracting strategy for the organization.
The candidate will have a strong work ethic, be a self-starter, and be able to be highly productive in a dynamic, collaborative environment. This position offers broad exposure to all aspects of the company’s business, as well as significant interaction with all the business leaders.
What You'll Do
- Leading and developing the overall network and provider relations strategy
- Developing, directing, and maintaining relationships with external and internal care providers and their organizations. Building and optimizing community-based partnerships
- Oversee and negotiate the most complex, competitive contractual relationships with providers according to prescribed guidelines supporting enterprise and local strategies
- Overall accountability for contract negotiations involving all provider types, including at-risk arrangements, IPA/PHO, hospital, and large provider groups
- Provide a solid understanding and expertise in the end-to-end aspects of provider contracting from modeling, configuration, utilization management, claims, and analytics, including provider risk sharing
- Advance the company strategy to drive value-based payment models and develop, negotiate, and manage complex Value-Based and Accountable Care (ACO) relationships
- May oversee the negotiation, implementation, and management of VBC agreements
- Represent the organization at related external provider meetings and conferences.
- Work closely with the Homeward clinical team to enable and improve clinical outcomes
- Responsible for understanding medical cost issues and medical cost ratios (MLRs) and initiating appropriate action to manage improvement initiatives
- Review analytics with medical economics and work with providers to develop collaborative initiatives that improve quality results and manage costs
- Communicating with internal/external parties by phone and in person may require travel to offsite locations. Ensuring a wide variety of cross-functional Stars strategic initiatives remains on track
- Ensure innovation and integration of Stars industry best practices
- Maintain a pulse of external environment factors that may impact the Stars program, including CMS policy direction
- Identify cross-enterprise initiatives necessary to achieve Stars and Member Experience objectives
- Responsible for providing guidance and direction to cross-functional team members as required in support of initiatives
- Stimulate strategic thinking in support of business direction
- Providing information, expert opinion, and thought leadership needed to support the attainment of Stars and Member Experience Objective
- Experience with Medicare Advantage, Medicaid, and ACA health plan lines of business
What You Bring
- 10+ years of experience in managed care
- Comprehensive understanding of hospital and physician financial issues and how to leverage technology to achieve quality and cost improvements for providers
- In-depth knowledge of various reimbursement structures and payment methodologies for hospitals and physicians
- Comprehensive understanding of value-based strategies and population health management
- Strong experience building and maintaining relationships with large hospitals/provider systems, integrated delivery systems, and large physician groups
- Solid leadership skills
- Understands the regulatory environment and ensures contractual compliance with federal and state requirements
What Shapes Our Company
- Deep commitment to one another, the people and communities we serve, and to care that enables everyone to achieve their best health
- Compassion and empathy
- Curiosity and an eagerness to listen
- Drive to deliver high-quality experiences, clinical care, and cost-effectiveness
- Strong focus on sustainability of our business and scalability of our services, to maximize our reach and impact
- Nurturing a diverse workforce with a wide range of backgrounds, experiences, and points of view
- Taking our mission and business seriously, but not taking ourselves too seriously– having fun as we build!
- Competitive salary, equity grant, generous paid time off
- Comprehensive benefits package including medical, dental & vision insurance with 100% of monthly premium covered for employees
- Unlimited Paid Time Off
- Company-sponsored 401k plan
Salary: $185,000 - $230,000 annually. Salary is based on qualifications, experience, skillset, and location.
At Homeward, a diverse set of backgrounds and experiences enrich our teams and allow us to achieve above and beyond our goals. If you have yet to gain experience in the areas detailed above, we hope you will share your unique background with us in your application and how it can be additive to our teams.
Homeward is an affirmative action and equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, disability, age, sexual orientation, gender identity, national origin, veteran status, or genetic information. Homeward is committed to providing access, equal opportunity, and reasonable accommodation for individuals with disabilities in employment, its services, programs, and activities.