Senior Healthcare Payment and Finance Advisor
Job Description
The Bureau of Equitable Health Systems (BEHS) in the Center for Health Equity and Community Wellness (CHECW) for the New York City Department of Health and Mental Hygiene (DOHMH) consists of a multi-disciplinary team that aims to engage primary care providers, hospitals, and other healthcare systems to implement evidence-based strategies; leverage information to support planning and technical assistance for providers and payers; advance policy to close the racial equity gap for priority health outcomes; and surface opportunities where health care can influence and connect individuals to social support and address the whole person, beyond physical ailments.
The mortality experienced due to COVID-19 made visible the inequities that low-income patients experience in accessing the healthcare system; as well as the marginalization of essential healthcare workers. As we move forward towards an equitable COVID-19 recovery, we need to develop innovative solutions to improve the performance, equity, and efficiency of the healthcare delivery system.
In this context, BEHS is looking to recruit a highly collaborative, experienced, and creative Senior Healthcare Payment and Finance Advisor to advise on three main areas of work:
1. Correction of policies that enable de-facto segregation of care.
2. Support for community and social services organizations to expand into a social care delivery system for Medicaid in a way that is easy-to-access for patients and providers, and financially sustainable.
3. Facilitate inclusion of preventive and social care services into value-based and capitated arrangements, inclusive of through blending and braiding approaches to social care.
Job Duties/Responsibilities
· Segregation of care:
o Collaborate with healthcare justice team in the development of a policy agenda to address de-facto segregation of care; with a focus on the correction of financial incentives for segregation and financial disincentives to income-integrated care.
o Collaborate with key stakeholders to raise awareness about the unintended segregation caused by legal and rational economic decision-making and create consensus on politically viable solutions to undo it.
· Whole-person care:
o Collaborate with clinicians and claims analysts to identify key segments of the population, providers, services etc. to target for high value interventions.
o Support the creation of a unified and operationally feasible vision for delivery of health-related-social-needs services so it maximizes impact on population health outcomes.
o Work with payers, providers, and social service organizations to co-create win-win payment models for health equity innovations; including blended and braided funding.
· Training
o Develop financial analysis skills among data and policy analysts
· Other
o Provide analysis of the unintended financial implications of policy and programs of interest for the health department.
o Investigate innovations in healthcare delivery and financing nationally and assess appropriateness and feasibility of implementation in New York.
Preferred Skills
- Advanced degree (masters, MD, PHD, JD) in business, healthcare finance, economics, or similar
- 10+ years of experience in roles that provide an in-depth understanding of financial incentives in the healthcare delivery and payment system.
- 3-5 years’ experience in progressively complex healthcare data analytics
- 3+ years of experience analyzing hospitals, Medicaid and/or Medicare Federal/State regulation.
- Health Insurance experience and proficiency in understanding professional and facility claims and managed care concepts such as risk adjustment, capitation, FFS, DRG, APG, APCs and other payment mechanisms
- Some experience in social service or community-based organizations, preferably related to contracting with government and/or insurance companies.
- Experience in Management Service Organizations, Independent Practice Associations, or other shared service organizations.
- Effective communication and ability to translate financial information to non-financial customers (internal and external)
- Experience in modeling financial impact of changes
- Strong ability to handle multiple projects including problem solving, research, analysis, and communication in a fast-paced environment