AmeriHealth Caritas Director, Value Based Programs in Philadelphia, Pennsylvania

Director, Value Based Programs


Your career starts now. We’re looking for the next generation of health care leaders.

At AmeriHealth Caritas, we’re passionate about helping people get care, stay well and build healthy communities. As one of the nation's leaders in health care solutions, we offer our associates the opportunity to impact the lives of millions of people through our national footprint of products, services and award-winning programs. AmeriHealth Caritas is seeking talented, passionate individuals to join our team. Together we can build healthier communities. If you want to make a difference, we’d like to hear from you.

Headquartered in Philadelphia, AmeriHealth Caritas is a mission-driven organization with more than 30 years of experience. We deliver comprehensive, outcomes-driven care to those who need it most. We offer integrated managed care products, pharmaceutical benefit management and specialty pharmacy services, behavioral health services, and other administrative services. Discover more about us at .

The primary purpose of the job is to:

Responsible for leading value based payment initiatives for AmeriHealth Caritas. Individual will be responsible for developing strategic value based goals and programs while leading a matrixed team through implementation, settlement and evaluation. Serve as subject matter expert for value based purchasing activities. These activities will include: Developing innovative programs designed to transition from fee-for-service reimbursement to a system based on value and population health, with an emphasis on risk based programs and bundled payment solutions

The Director, Value Based Programs will also be responsible for the following:

  • Providing analytical support for value-based programs, including independently monitoring/measuring the performance of the initiatives by leveraging utilization, financial, clinical, and benchmark data from multiple internal and external sources.
  • Performing analysis, summarizing results, and over-seeing value based payments while adhering to established standards and processes.
  • Monitoring and researching health care and health industry developments on best practices and initiatives in developing new value based and bundled payment models to support more coordinated, efficient, and quality-driven healthcare.
  • Developing short and long term value based strategy across the organization
  • Ensures that an appropriate medical economics discipline in incorporated into all reporting and analytics. Demonstrated appropriate use of statistical principles in reporting and analytics.
  • Effectively manages a large and broad portfolio of work and projects, ensuring that goals, requirements, and outcomes are clearly understood and that the appropriate resources are used to deliver superior effective products in a timely and efficient manner. Manages work in a well-planned and organized manner.
  • Collaborates with internal partners (IS, PMO, Business) to improve our practices and ensure they are integrated with the broader community.
  • Understands the strategic priorities of the company and makes strong business decisions in support of achieving business goals.
  • Demonstrated ability to collaborate effectively with cross-functional management staff and key business customers to achieve strategic objectives.
  • Adjusts readily to changing priorities and assignments, and manages staff workload accordingly.
  • Assists with New Business Activations to ensure a smooth and efficient installation.
  • Assembles and maintains a talented, high-performance team, and improves overall performance of the Department in a measurable way. Deals promptly and effectively with substandard staff performance.
  • Manages and controls departmental expenditures within established budgets.
  • Demonstrates excellent listening and communication skills.
  • Deals proactively and tactfully with difficult customers, viewing such situations as opportunities to continually build stronger working relationships.
  • Actively and effectively participates in the development and implementation of new business.
  • Is fully oriented to the strategic goals and initiatives of the Department, Company, individual Plans, and the industry. Effectively translates goals into actionable work plans for individual staff.
  • Performs other job related duties and projects as assigned. Education & Experience:
  • Bachelors’ degree required, Masters’ degree preferred.
  • Five to ten years of Medical Economics, Informatics or medical management and analytic reporting.
  • Five or more years management experience required, managed care environment preferred