Value-Based Expert

Responsibilities:

• Deliver advanced reimbursement, financial impact, and performance analyses to support managed care negotiations and payer strategy.
• Design and evaluate value-based payment models, including shared savings, quality measures, risk corridors, and attribution methodologies.
• Develop pro forma models and conduct sensitivity and stress testing to assess the financial impact of contract changes, cost initiatives, and market trends.
• Monitor contract and value-based program performance, identifying underpayments, compliance issues, adverse payment trends, and financial risk.
• Produce monthly forecasts and financial reports covering value-based performance, reconciliation, and variance analysis.
• Lead quarterly and annual reconciliation audits to ensure payer compliance and identify contract performance gaps.
• Create scalable tools, analytics, and exe...