System Vice President – Payer Strategy Innovation

CommonSpirit Health was formed by the alignment of Catholic Health Initiatives(CHI) and Dignity Health. With more than 700 care sites across the U.S.,fromclinics and hospitals to home-based care and virtual care services,CommonSpiritis accessible to nearly one out of every four U.S. residents. Our world needscompassion like never before. Our communities need caring and our families needprotection. With our combined resources, CommonSpirit is committed to buildinghealthy communities, advocating for those who are poor and vulnerable, andinnovating how and where healing can happen, both inside our hospitals and out inthe community.

TheSystem VP, PayerStrategy Innovation is responsible for leading initiativeson behalf of the Payer Strategy & Relationships (PSR) function to createinnovative and transformative payer strategies, relationships and agreementsthat drive the future of CommonSpirit Health by optimizing revenue andincreasing the number of people we serve. This role will lead the PayerStrategy Innovation team in developing payer strategies to advance strategicpartnerships, merger/acquisition activities, new care delivery/servicereimbursement models, enterprise business line integration, value-basedagreement strategy and growth, and overall efforts to innovative payerstrategies to maximize value for CommonSpirit Health. This role positionsCommonSpirit Health for sustainable financial performance throughsophistication and innovation in payer strategies and the translation ofprovider/system value into payer reimbursement strategies.

TheSystem VP of Payer Strategy Innovation is a key member of the CommonSpiritHealth leadership team, directly interacting with executive leaders across theorganization and contributing to the ministry becoming a system of choicethrough an integrated operating organization with a healthy culture built onrelationships, trust, & teamwork. This role will make significantcontributions to the development and implementation of system and localstrategy, transformation to a clinical enterprise, successful physicianalignment strategies, achievement of patient experience & employee engagementgoals, and achieving budgets. This position is responsible for innovative payerstrategies that impact payer agreements with over $13B of annual net revenue and over 2Mpeople attributed to value-based agreements.

Essential Key Job Responsibilities
1. CommonSpirit Health System leader responsiblefor payer strategy innovation to advance strategic partnerships,merger/acquisition activities, new care delivery/service reimbursement models,enterprise business line integration, value-based agreement strategy andgrowth, and overall efforts to maximize the value of strategic payerpartnerships.

2. Directly engages with the senior leadership team across CommonSpirit Health todesign strategic initiatives that influence payer and employer strategies forthe entire ministry.

3. Leads, manages, mentors and develops Payer Strategy Innovation team.

4. Engages in cross-functional initiatives to drive integration and alignmentacross CommonSpirit Health to improve operational and financial performance,increase employee engagement, and deliver on our ministry’s commitment toimproving the health of those we serve.

5. Evaluates innovative payer partnership opportunities to ensure alignment withCommonSpirit Health’s transformative strategies and PSR’s National/Divisionalstrategic plans (JOA/JV, co-branded/white labeled payer products, preferrednetwork partnership, narrow/tiered network partnerships, etc.).

6. Develops, implements and monitors success of innovative national and localpayer partnership strategies to drive sustainable financial performance.

7. Acts as the System PSR lead for all payer-related merger, acquisition anddivestiture activities.

8. Translates value generated from CommonSpirit Health providers, ClinicallyIntegrated Networks/ACOs, and population health management programs into payercontracts and reimbursement models.

9. Designs strategy and manages system participation and performance in novelinnovative care models to ensure appropriate reimbursement models accompanyprogram participation.

10. Designs and implements reimbursement strategies for new services/care deliverymodels to optimize revenue and margin (telehealth, hospital at home, etc.).

11. Collaborates with System and Division Finance, Legal, Enterprise Business Line,Strategy and Business Development, and Clinically Integrated Network Operationsareas to advance the alignment and accountability model in order to maximizethe value of CommonSpirit Health payer contracts.

12. Stays current with emerging payer trends, new reimbursement methodologies,payer activity, products and delivery channels.

Successin this role will be evident in revenue generation and contribution marginsachieved through fee-for service and value-based reimbursement effectiveness,and the organization’s ability to translate provider/CIN/system value intoeffective value-based models that reward CommonSpirit Health for improving thehealth of defined populations while delivering affordable access and serviceexcellence.

Keyinitial success indicators for this role include:

Designand implement a high quality, integrated and aligned Payer Strategy Innovationstructure that delivers value across the System.

Develop reimbursement strategies and contracting guidelines for new services/caredelivery models to optimize revenue and margin (telehealth, hospital at home,etc.).
Deliver effective support across the System to advance payer-related merger,acquisition and divestiture activities.
Demonstrate concrete and relevant operating income and contribution marginlinkages between payer contracts and provider/CIN/system value generation.

Non-essential Job Responsibilities
1. Educate key stakeholders on PSR initiativesand objectives

2. Coordinate system reporting to address internal and external requests

3. Other duties as required by PSR Leadership

RequiredMinimum Experience

• 15+ years industry experience

Required Minimum Knowledge, Skills and Abilities

• 10+ years progressiveleadership responsibility and experience in large healthcare organizationsand/or integrated healthcare delivery systems