Develop and execute the IPA's strategic plan, aligning continuing care members around shared objectives in managed care contracting, care management, and quality performance. Serve as the primary liaison between the IPA, GNYHA leadership, vendors, member facilities, and external stakeholders including DOH, CMS, and payers. Lead negotiation strategy and contract modeling for managed care and risk-bearing arrangements, including delegated care management and quality incentive programs. Oversee governance activities, ensuring compliance with federal and state IPA/CIN regulations and adherence to antitrust and data-sharing protocols.
Build and manage the IPA's administrative infrastructure, including membership relations, financial reporting, and contracting operations. Develop standardized clinical, financial, and quality metrics to support value-based arrangements and shared savings models. Establish and coordinate working groups and committees (Clinical Integration, Finance, Data Analytics, and Quality & Compliance). Manage vendor relationships for data analytics, care coordination, and workflow intelligence platforms.
Develop and manage the IPA's annual operating budget. Supervise payer data analysis, rate benchmarking, and actuarial modeling to identify opportunities for collective financial improvement. Support the creation of facility-level impact analyses and modeling for new initiatives.
Collaborate with GNYHA's Health Economics and Finance team to provide technical guidance and education to IPA members on rate-setting updates, acuity scoring, and documentation practices that drive payment accuracy under both Medicaid and Medicare systems.
Work Schedule: A hybrid model with the expectation to work physically in our office Tuesdays and Wednesdays as mandatory in-office days with a third in-office day at your discretion, in coordination with your supervisor and in accordance with the business needs of your department.
Master's degree in health administration, public policy, business, or a related field. At least 6 years of progressive experience in healthcare management, managed care contracting, or post-acute operations. Excellent communication, coalition-building, and stakeholder management skills. Deep knowledge of New York State Medicaid financing, Medicare Advantage, and SNF reimbursement methodologies. Strong financial modeling and analytic capability, including comfort working with rate models and utilization data. Proven track record of establishing strong relationships with hospital and SNF leadership, including C-suite executives. Experience leading CIN initiatives. Familiarity with CMS IPA/CIN regulatory requirements and state oversight frameworks. Understanding of hospital and SNF alignment, care transitions, and post-acute quality reporting. Demonstrated ability to operate at both the strategic and tactical levels within complex, multi-stakeholder environments.