Description As a not-for-profit organization, Partners HealthCare is committed to supporting patient care, research, teaching, and service to the community by leading innovation across our system. Founded by Brigham and Women?s Hospital and Massachusetts General Hospital, Partners HealthCare supports a complete continuum of care including community and specialty hospitals, a managed care organization, a physician network, community health centers, home care and other health-related entities. Several of our hospitals are teaching affiliates of Harvard Medical School, and our system is a national leader in biomedical research.
We?re focused on a people-first culture for our system?s patients and our professional family. That?s why we provide our employees with more ways to achieve their potential. Partners HealthCare is committed to aligning our employees? personal aspirations with projects that match their capabilities and creating a culture that empowers our managers to become trusted mentors. We support each member of our team to own their personal development?and we recognize success at every step.
Our employees use the Partners HealthCare values to govern decisions, actions and behaviors. These values guide how we get our work done: Patients, Affordability, Accountability & Service Commitment, Decisiveness, Innovation & Thoughtful Risk; and how we treat each other: Diversity & Inclusion, Integrity & Respect, Learning, Continuous Improvement & Personal Growth, Teamwork & Collaboration.
Overview? The Government Payment Policy Unit, within the Payer Strategy & Contracting Department, is responsible for the following functions pertaining to government payer revenue: ?Assess the financial impact of Medicare and Medicaid payment updates, including pay-for-performance and other value-based purchasing programs; ?Develop, support, and implement public payer strategy and advocacy through analysis and discussion with internal stakeholders and government agencies; ?Monitor the development of federal and state health care reform efforts in order to assess potential financial implications for Partners; ?Produce revenue projections for the annual budget and five-year capital framework; ?Analyze and report government payer revenue, cost, and other relevant information to internal stakeholders, federal and state agencies, and other external parties; ?Participate in internal and external task forces and advisory groups, including those sponsored by provider associations and government agencies Reporting up through Partners? Vice President for Payer Strategy & Contracting and Partners? Chief Strategy Officer, the Unit works closely with CFOs, finance leadership, and staff throughout Partners on a broad range of government payer issues. The Unit also works closely with Partners Community Health, Government Affairs, Population Health Management, and Quality, Safety and Value to advise and support advocacy strategy.
Principle Duties and Responsibilities
In this role, you will:
1.Analyze legislative and regulatory proposals that affect government payer revenue received by Partners acute hospitals and post-acute facilities, including: ? Development of summaries and presentation materials for finance and quality leaders; ? Assessment of financial impact to inform internal stakeholders, including Corporate Budget, Revenue and Reimbursement, and finance staff at the institutions; ? Consultation with finance leaders, staff at the institutions, and pertinent central departments such as Community Health, Corporate Budget, Government Affairs, Quality, Safety & Value, and Revenue & Reimbursement; and ? Drafting comment letters in collaboration with internal and external subject matter experts.
2.Contribute to the annual budget and multi-year forecast process as it relates to government revenue, including: ? Collaborating with key staff in Corporate Budget, Revenue and Reimbursement, and the institutions; ? Developing and maintaining detailed reimbursement models 3.ormulating projections of future revenue in collaboration with experts, both internally (Community Health, Corporate Budget, Government Affairs, and Quality, Safety & Value) and externally (e.g., government agencies and provider associations); ? Developing and recommending budget and forecast assumptions and determining impact; and ? Disseminating budget assumptions to finance leaders at the institutions, ensuring their understanding and assimilation of these assumptions into Institutional budgets and forecasts.
4.In conjunction with the Quality, Safety & Value staff, assist with the management of government revenue payments tied to federal and state pay for performance programs, including: ? Monitoring performance and projecting financial impact; ? Providing financial analysis and related support to key quality committees; ? Developing and providing periodic and ad hoc reports to senior finance leaders; ? Supporting advocacy efforts by senior management, Government Relations, quality and clinical leaders.
5.Assist with government revenue related projects to execute high quality deliverables, including: ? Scoping, designing, and implementing project plans; ? Dissemination of government payment policy knowledge.
6.Manage Government Payment Policy staff in a manner that fosters employee engagement, including: ? Creating an environment of trust and respect ? Informing staff of how their work affects the department?s goals and priorities ? Understanding and aligning staff motivation with organization?s visions and goals ? Recognizing and rewarding achievement and value created for the organization ? Focusing on development necessary to ensure success through commitment to measure performance and establish accountability through continuous communication and feedback
1.Monitor changes in legislative, regulatory and administrative activity affecting revenue from Government Payers ?In conjunction with Partners Government Affairs, outside consultants and provider associations (MHA, AHA, AAMC), provide ongoing monitoring of legislative and regulatory proposals, changes and updates. ?Maintain knowledge of structure and processes and monitor activity and communications from agencies charged with oversight and implementation of government revenue programs, including Center for Medicare and Medicaid Services (CMS) and Division of Medical Assistance (Massachusetts Medicaid).
?Working closely with key departments within PHS Finance and Entity Finance, ensure all budget / forecasting assumptions are accurately incorporated into models and results disseminated. ?Model various payment policy scenarios, including legislative proposals (e.g., deficit reduction), regulatory changes and annual payment rules
2.Perform, advise and support analyses of 1) Government Quality and Performance Programs (e.g. Medicaid Pay-for-Performance, Medicare Value Based Purchasing, and HITECH), 2) Clinical Outcome Related Payment Policy (e.g. readmissions, Hospital Acquired Conditions) and 3) Alternative Payment Proposals (e.g. Accountable Care Organization, Bundles): ?In conjunction with PHS and institution leadership, develop strong working knowledge of clinical, operational and reporting requirements in order to best inform financial analyses ?Draft presentations outlining policy changes and financial impact to Partners ?Monitor each program?s development and formulate balanced and thoughtful comment letters on behalf of Partners to state and federal agencies to promote positive change in health care ?Work with corporate and hospital quality and IS leaders and staff to support the development of strategies to meet full compliance and ensure optimal performance under various programs, e.g., Medicare Value-Based Performance, Medicaid Pay-for-Performance and HITECH ?Represent Partners Finance in external meetings regarding related programs 3.Provide ad hoc support, guidance and expertise regarding government payment policy, payment methodologies, rates, compliance reporting and appeals ?Respond to requests from corporate and entity staff
4.Serve as resource for junior analytic staff in understanding and analyzing government payment policy
Qualifications ?Bachelor?s Degree required; Master?s Degree with Health concentration, such as Health Policy / Management, MBA, Public Health, preferred ?Five years of progressive hospital reimbursement experience, preferably in an academic medical center, large consulting firm, government agency, or hospital association (Master?s Degree in the above fields may substitute for two years of job experience) ?In-depth knowledge of governmental payer payment methodologies ?Strong project management and organizational skill ?Strong ability to work effectively and efficiently in a large, complex, fast-paced, matrix-style organization ?Strong quantitative, analytical, and statistical skills, as well as the ability to effectively interpret, summarize and communicate the results of complex data analysis ?Strong skills in Excel, Access/SQL, and Power Point and ability to access complex databases and aptly use analytic and presentation tools
EEO StatementPartners HealthCare is an Equal Opportunity Employer & by embracing diverse skills, perspectives and ideas, we choose to lead. All qualified applicants will receive consideration for employment without regard to race, color, religious creed, national origin, sex, age, gender identity, disability, sexual orientation, military service, genetic information, and/or other status protected under law.
Associated topics: anesthetist, care unit, clinical psychologist, drug use, hematology, malaria free, medicaid, nurse practitioner, oncology, registered nurse
* The salary listed in the header is an estimate based on salary data for similar jobs in the same area. Salary or compensation data found in the job description is accurate.