Senior Director, Delivery System and Payment Transformation

Position Summary The Senior Director, Delivery System and Payment Transformation leads activities related to health plan coding and billing, provider fee‑for‑service and alternative payment models, and CMS Innovation Center models. The role includes assessing market trends, educating members, developing policy legislative and regulatory positions, and collaborating with AHIP member plans and other stakeholders. The position develops advocacy materials and collaborative cross‑industry relationships that support AHIP's advocacy efforts at the state and federal levels and identifies and shares promising practices by health insurance providers in payment and delivery system reform. Finally, the position leads several large multi‑stakeholder projects to assess participation in and advance value‑based care. Essential Duties And Responsibilities Maintain tracking system of key market trends, 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 and draft legislation by Congress or state legislative bodies. Communicate industry positions effectively through interactions with external organizations in various 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 and Coding by recruiting speakers, preparing materials for member calls and meetings, developing interactive, collaborative initiatives, articulating consensus on issues, and ensuring member engagement. Lead nominations of members for AHIP and other vacant seats associated with coding, billing and payment as well as support members once appointed. 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. Perform other tasks as required or assigned. Physical Demands While performing the duties of this job, the employee is regularly required to see, talk and hear. In addition, the employee frequently is required to stand, walk, use hands to finger, handle or feel, and reach with hands and arms, communicate verbally, use computer and other technology (including keyboarding). Mental Demands Employee must have a high capacity for logical thinking, be able to cope effectively with stressful demands involving high levels of responsibility and urgent deadlines, remain calm in conflict situations, focus on mission‑critical matters but also have the ability to switch quickly from one project or demand to another (and back again). Minimum Education and Experience Bachelor’s Degree and/or equivalent experience. Minimum of 5–7 years of experience analyzing and developing policy on health‑related regulations and legislation. Strong understanding of and experience working with federal or state agencies and key external partners on issues of strategic interest. Experience writing comment letters, testimony, white papers, newsletters, advocacy, and consumer‑facing materials. Experience presenting to large multi‑stakeholder groups on complex health industry issues. Other Qualifications Strong knowledge of regulations impacting healthcare providers. Significant knowledge of provider fee‑for‑service payments and value‑based payment model design. Knowledge of health plan operations is preferred. Experience interpreting/summarizing/developing health policy at the Federal or State level. Excellent analytical skills. Ability to work with diverse stakeholders and think strategically. Strong understanding of financing and delivery of care in the U.S. Working knowledge of health care coding preferred. Experience driving consensus across stakeholders. Strong time and project management skills to meet ongoing deadlines. Ability to work favorably as part of a team, understand and follow direction. Excellent oral and written communication skills. Ability to build collaborative relationships. Ability to influence others. Ability to identify and seek information. Analytical and conceptual thinking skills. Expected Hours of Work This is a full‑time position. Days and hours of work are Monday through Friday, 8:30 a.m. to 5:30 p.m. Disability Specifications AHIP will make reasonable accommodations in compliance with the Americans with Disabilities Act of 1990. Other Duties 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. AHIP is an Equal Opportunity Employer. #J-18808-Ljbffr Nashville Public Radio