AVP, Healthcare Economics

At Claritev, we pride ourselves on being a dynamic team of innovative professionals. Our purpose is simple - we striveto bend the cost curve in healthcare for all. Our dedication to service excellence extends to all our stakeholders - internal and external - driving us to consistently exceed expectations. We are intentionally bold, we foster innovation, we nurture accountability, we champion diversity, and empower each other to illuminate our collective potential.

Be part of our amazing transformational journey as we optimize the opportunity towards becoming a leading technology, data, and innovation voice in healthcare. Onward and Upward!!!

JOB SUMMARY: The AVP, Healthcare Economics (HCE) is responsible for planning, developing, and directing all aspects of business and provider information supporting Claritev's Network Development team. In addition, this position is responsible for the development and oversight of the Request for Proposal (RFP) process related to Government Programs opportunities, ensuring that Claritev network composition and metrics accurately represent the potential financial value to current and prospective Claritev customers.

JOB ROLES AND RESPONSIBILITIES:

1. Direct, develop, refine, and lead the HCE organization in business and provider information activities that will result in company growth and profitability.

2. Identify competitive areas and target these areas to make Claritev more competitive through a realignment of existing discount and penetration reporting to coincide with sales and marketing regions.

3. Use Metropolitan Statistical Analysis (MSA) statistics to assess strengths and weaknesses and to deliver performance reporting by product and provider type to inform targeted cost management improvement initiatives.

4. Explore and implement where feasible, product and market specific exclusive arrangements with large national provider chains.

5. Establish, implement, and maintain Network reporting standards to ensure that Claritev Executive Management, Network Development leadership and network contractors have reliable and accurate provider information on which to base current and future business decisions.

6. Direct the monitoring of program effectiveness and develop and enhance processes to increase the effectiveness of Claritev Network Development activities.

7. Oversee the analysis of industry best practices in order to develop and maintain market competitive provider reimbursement schedules.

8. Provide leadership for the Network Development area through long-range forecasting and planning, mid-range operating plan and real time management.

9. Partner in the development and execution of Claritev's Wrap Network development strategy.

10. Select, develop and evaluate staff to ensure the efficient operation of department.

11. The position responsibilities outlined above are in no way to be construed as all encompassing. Other duties, responsibilities, and qualifications may be required and/or assigned as necessary.

12. Collaborate, coordinate, and communicate across disciplines and departments.

13. Ensure compliance with HIPAA regulations and requirements.

14. Demonstrate commitment to the Company's core values.

Please note due to the exposure of PHI sensitive data - this role is considered to be a High Risk Role.

JOB SCOPE:

The AVP, Healthcare Economics has significant impact on the image, quality, and effectiveness of service to internal and external Claritev customers as well as on overall Network Development strategies and financial and operating business plans. An incumbent has a high level of exposure associated with and responsibility in managing the company's operations through directing a staff of administrative, professional, and managerial personnel. In addition, this job strategically partners with other leadership roles to plan strategies and programs to ensure efficient operations and achievement of business objectives.