Working under the general direction of Senior Vice President, Private Market Innovations & Quality Initiatives, the Executive Director, Delivery Systems and Payment Transformation is responsible for assessing market trends, educating members, developing policy, and responding to regulatory and legislative proposals in the areas of health plan accreditation standards, fee-for-service payments to providers, innovations in healthcare delivery and payment models, healthcare data and interoperability, and other issues as they arise. This position will also participate in external meetings on behalf of the organization and be responsible for communicating the industry’s positions and advancing industry interests.
Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
Maintain tracking system of key market trends and catalog trends and best practices pertaining to value-based care and payment.
Prepare member written educational materials including regulatory summaries, issue briefs, slides, member memos, and newsletter articles.
Track, prioritize, analyze implications, sequence activities, develop policy, solicit member feedback, and lead comment responses to proposed regulations or requests for information issued by CMS and other federal agencies as well as draft legislation by Congress or state legislative bodies.
Support development of comment responses on health plan standards from key organizations such as NCQA and URAC.
Communicate industry positions effectively through interactions with external organizations in a variety of ways: one-on-one conference calls, multi-stakeholder meetings, and presentations.
Develop and foster relationships with key contacts at member health insurance plans and other associations to advance member interests and identify opportunities for additional collaborations on initiatives of strategic interest to the AHIP membership.
Support Clinical Innovations workgroups including but not limited to Value-based Care, Health Information Technology, and Coding by recruiting speakers, preparing materials for member calls and meetings, developing interactive collaborative initiatives, and articulating consensus on issues and ensuring member engagement.
Serve as subject matter expert on the identified issues acting as a resource to internal and external partners including responding to member and intra-divisional inquiries.
Support interdepartmental priorities by providing content for time-sensitive press inquiries, policy statements on federal and state proposals, testimonies, etc.
Other tasks and duties as assigned.
This position has no supervisory responsibilities.
This job operates in a professional office environment. This role routinely uses standard office equipment.
The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job.
While performing the duties of this job, the employee is regularly required to talk or hear. The employee frequently is required to stand; walk; use hands to finger, handle or feel; and reach with hands and arms. Specific vision abilities required by this job include close vision, distance vision, color vision, peripheral vision, depth perception, and ability to adjust focus.
Position Type/Expected Hours of Work
This is a full-time position. Standard days and hours of work are Monday through Friday, 8:30 a.m. – 5:30 p.m., however may require long hours and weekend work.
Up to 10%.
AHIP will make reasonable accommodations in compliance with the Americans with Disabilities Act of 1990.
AHIP is an Equal Opportunity/Affirmative Action Employer.
Please note this job description is not designed to cover or contain a comprehensive listing of activities, duties, or responsibilities that are required of the employee for this job. Duties, responsibilities, and activities may change at any time with or without notice.
Required Education and Experience
Master of Public Health, Health Services Administration, Public Policy, Business Administration, or related field preferred and/or equivalent experience.
Seven years or more of experience in health care and/or health plan operations, health policy, or federal programs preferred.
Experience working with health insurance plans, federal or state agencies, and key external partners on issues of strategic interest.
Experience analyzing and developing policy on health-related regulations and legislation.
Experience writing comment letters, testimony, white papers, newsletters, advocacy materials, and consumer-facing materials.
Experience presenting to large multi-stakeholder groups on complex health industry issues.
Experience working in a collaborative environment.
Strong knowledge of regulations affecting both payers and providers.
Significant knowledge of health plan operations, provider contracting and alternative payment model design
Familiarity with provider and/or plan quality measurement
Knowledge of healthcare information interoperability and public healthcare programs
Experience interpreting/summarizing/developing health policy at the Federal or State level
Excellent analytical, oral and written communication skills
Ability to work with diverse stakeholders and think strategically
General understanding of financing and delivery of care in the U.S.
Experience driving consensus across stakeholders
Strong time and project management skills to meet ongoing deadlines
Proficiency in Microsoft Office applications; specifically, MS Word, PowerPoint, and Excel.
Internal Number: 5
As a national trade association representing the health insurance industry, AHIP combines the fellowship of a small organization with the stability and strength our members represent. Here you can make a positive difference to the 200 million plus Americans, who our members serve. We foster innovation and opportunity. If you are looking for challenging and rewarding work, consider an AHIP career.