Working under the general direction of Senior Vice President, Private Market Innovations & Quality Initiatives, the Vice President, Private Market Innovations is responsible for leading efforts in the Clinical Affairs to assess market trends, educate members, develop policy and respond to regulatory and legislative proposals in the areas of health plan accreditation standards, health plan payment to providers, and innovations in healthcare delivery models. This position will also represent the organization at external meetings and be responsible for communicating the industry’s position and advancing industry interests.
Identify key strategic regulatory and market changes pertaining to payment and delivery system reform and health plan accreditation.
Track, identify priorities, analyze implications, sequence activities, 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 that pertain to payment and delivery system reform.
Track, identify priorities, analyze implications, sequence activities, solicit member feedback, and lead comment responses on health plan standards from key organizations such as NCQA and URAC.
Lead efforts on aspects of payment and delivery system redesign as outlined in AHIP’s long-term strategic plan.
Interact with external organizations in a variety of ways: one-on-one conference calls, represent the industry in multi-stakeholder meetings on a variety of topics, and present at conferences. Communicate effectively industry position and value on these topics.
Support the Integrated Delivery Network Workgroup by establishing priorities, recruiting speakers, preparing materials for member calls and meetings, facilitating member calls and meetings, developing and articulating consensus on issues and ensuring member engagement.
Support other Clinical Affairs team members on cross-cutting issues such as quality measurement, social determinants of health and interoperability.
Serve as liaison with other AHIP departments in support of cross-functional projects.
Other tasks and duties as assigned.
Skills and Expertise:
• Significant knowledge of health plan operations, provider contracting and alternative payment model design, 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 • Experience presenting to senior executives and speaking at large events • 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 with Microsoft Office applications; specifically, MS Word, PowerPoint and Excel.
• Minimum of Master of Public Health, Health Services Administration, Business Administration or related
• Minimum of 7 years of experience in healthcare / Health plan operations, health policy or federal programs • Strong knowledge of regulations affecting both payers and providers.
Certifications: • None
Physical Work Activities & Conditions:
• Continuous sitting for prolonged periods more than 2 consecutive hours in an 8-hour day. • Keyboard use of greater or equal to 50% of the workday. Percent of Travel:
Up to 25%.
The purpose of a job description is to describe the overall function and general responsibilities of a job. Job descriptions are used in hiring and training and to provide employees with a better understanding of employer expectations. Actual job functions and duties will vary as job responsibilities and business needs require.
Equal Opportunity Employer
America’s Health Insurance Plans (AHIP) is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, age, disability, religion, sex, sexual orientation, gender identity, national origin, or status as a protected veteran.
Interested candidates are requested to visit AHIP’s Career Website: https://www.ahip.org/about-us/careers-at-ahip/ for further instructions on resume submission.
How to Apply
Equal Opportunity Employer M/F/D/V
AHIP is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, age, disability, religion, sex, sexual orientation, gender identity, national origin, or status as a protected veteran. AHIP does not sponsor applications for work visas.
In order to request consideration for an opened position at AHIP, all candidates must complete an AHIP Job Application and submit it, along with a current resume and cover letter that includes your requested salary range. We also ask that you complete and return the three voluntary forms that aid us in our attempt to meet our affirmative action goals:
• Voluntary Applicant Self-Identification of Disability • Voluntary Applicant Race/Gender Self-Identification Form • Voluntary Veteran Self-Identification Form
All voluntary documents will be used for Affirmative Action tracking purposes only, and will be held confidentially in our Human Resources Department. They will not be viewed during the hiring process.
Once completed, all forms should be returned to our recruitment mail box at: email@example.com or mail to: America’s Health Insurance Plans (AHIP) ATTN: HR Dept/CAVPPMI 601 Pennsylvania Avenue, NW South Building, Suite 500 Washington, DC 20004
Additional Salary Information: Salary is commensurate with experience
Internal Number: CAVPPMI
About America's Health Insurance Plans (AHIP)
America’s Health Insurance Plans (AHIP) is the national trade association representing the health insurance community. AHIP’s members provide health and supplemental benefits through employer-sponsored coverage, the individual insurance market, and public programs such as Medicare and Medicaid. AHIP advocates for public policies that expand access to affordable health care coverage to all Americans through a competitive marketplace that fosters choice, quality, and innovation.