EXECUTIVE, PAYOR ENGAGEMENT

MAKE A DIFFERENCE AT OCHIN

MAKE A DIFFERENCE AT OCHIN

OCHIN is a nonprofit leader in health care innovation and a trusted partner to a growing national provider network, providing the clinical insights and tailored technologies needed to expand patient access, grow and connect care teams, and improve the health of rural and underserved communities.

We are hiring a number of new positions to meet increasing demand. When you choose to join OCHIN, you have the opportunity to continuously grow your skills and do meaningful work to help fulfill our vision of good health and well-being for everyone.

At OCHIN, we value the unique perspectives and experiences of every individual and work hard to maintain a culture rooted in our values.

Founded in Oregon in 2000, OCHIN employs a growing virtual workforce of more than 1,200 skilled professionals, working remotely across 49 states. We offer a generous compensation package and are committed to supporting our employees' entire well-being by fostering a healthy work-life balance and opportunity for professional advancement. We are curious, collaborative learners who strive to live our values every day. OCHIN is excited to support our continued national expansion and the increasing demand for our innovative tools and services by welcoming new talent to our growing team.

Position Overview

OCHIN is building a new line of business in value-based payment (VBP) enablement and risk contracting.

The role of Executive-Payor Engagement will co-lead the design, launch, and engagement of OCHIN members into OCHIN's ACO business and chart the engagement and enrollment roadmap toward OCHIN's value-based payment platform that meets/exceeds enrolment goals. Over time, this role could expand into Medicare Advantage, Medicaid, and other risk-bearing ventures. You will be the bridge between strategy, operations, partnerships, and clinical enablement - owning member engagement, pipeline growth for the VBP business line.

This position will be the lead on behalf of OCHIN working in partnership with internal teams as well as our ACO partner organization to build and executive on an engagement initiative that ensures high quality communications, delivering program content and value propositions and resulting in ACO enrollments that meet or exceed annual goals. This position will work with a multidisciplinary team (business development, account management, contracts, data & analytics, operations, provider engagement, clinical quality, compliance) and collaborate across OCHIN's broader infrastructure (IT, analytics, finance, product, member services) as well as with our ACO partner to identify, educate and enroll members into our high-performing value-based care arrangements that advance OCHIN's mission for health centers.

Essential Duties

Strategy & Business Development

• Define and executive on the strategic enrollment engagement strategy that connects the value of our VBP/ACO business to our members in partnership with the CXO.
• Lead payer and market engagement to source, negotiate, and secure members in our ACO working collaboratively with our partner and internal multi-disciplinary team.
• Evaluate opportunities (lines of business, markets, states) and build business cases
• Partner with internal stakeholders (product, tech, analytics) to define the product / service offering, operational model, pricing, margins, value proposition
• Monitor industry trends, regulatory changes (Medicare, Medicaid, CMS, state policies) and adapt strategy accordingly

Operational Leadership & Execution

• Manage and report out the engagement outcomes to ensure meeting current enrollment goals and build the pipeline for successive years.
• Be thoroughly knowledgeable on all operational functions for the ACO / VBP business: provider enablement, quality programs, member attribution, technical offerings, provider engagement, performance reporting, audits, compliance in order to speak to the value of our offering
• Lead engagement activities up to signed enrollment and hand-off to the operational teams.
• Ensure alignment across analytics, IT infrastructure, data flows, and tools to support reporting, insights, and provider incentives

Provider & Network Management

• Cultivate strong relationships with participating health centers, networks, hospitals and provider partners
• Serve as primary liaison for provider leadership, ensuring alignment of incentives, operational support, and performance improvement
• Drive provider onboarding, engagement, performance management, and issue resolution
• Collaborate on clinical models, care pathways, shared services, and population health strategies

Quality, Compliance & Risk Management

• Understand and communicate the value of OCHIN ACO and how our tools and services support shared savings to the members.
• Understand and communicate the mechanics of value-based pay programs including quality and performance metrics (e.g., patient outcomes, cost, utilization, care gaps) and how VBP can enhance the financial sustainability of the member.
• Manage risk exposure, downside protections, stop-loss, reinsurance, audit risk, regulatory compliance
• Coordinate with legal, compliance, and risk teams to mitigate contractual or regulatory liabilities

Team Leadership & Culture

• Partner with OCHIN and our Payor Partner high-performing cross-functional team (direct and indirect reports across operations, analytics, provider engagement, contracting)
• Represent OCHIN externally - in industry forums, payers, state/regional stakeholder groups, conferences
• Mentor, develop, and grow talent in the VBP organization
• Inform executive and internal teams of industry emerging trends, information
• Foster a culture of operational excellence, accountability, collaboration, and continuous improvement

Required / Core

• Bachelor's degree in Public Health, Healthcare Administration, Business, or related field is required
• 10-15+ years of leadership experience in value-based care, population health, ACOs, managed care, or risk contracting
• Mission-oriented, collaborative mindset (especially working with health centers, FQHCs)
• Demonstrated P&L / business management experience
• Proven track record of launching and scaling VBP / ACO or risk-based lines of business that meets/exceeds business goals
• Experience building and managing member relationships
• Strong operational capabilities (claims, attribution, quality, utilization, compliance)
• Deep analytical fluency: able to work with data, interpret performance, translate into operational levers
• Excellent stakeholder management, influencing and negotiation skills
• Executive presence and ability to represent the organization externally
• Travel up to 20% is required

Preferred / Plus

• Experience in Medicare (especially MSSP / REACH / MA) and Medicaid VBP
• Experience with enabling / platform models (i.e. managing provider enablement, contracting services)
• Familiarity with health center / safety-net environment and federal programs
• Background in technology-enabled operations, analytics platforms, health IT
• Advanced degree (MBA, MHA, MPH) or equivalent

Base Pay Overview

OCHIN uses broadened pay ranges to support equitable and market-aligned compensation practices. The final offer will be based on a variety of factors, including relevant skills, certifications, education, experience, training, responsibilities, internal equity, and market data.

Physical Requirements/Work Environment:

• Constant interpersonal skills, teamwork, and customer service. Frequent creativity, mentoring, presentations/teaching. Occasional decision making and independent judgment or action.
• Reading, speaking, writing, and understanding English.
• While performing the duties of the job, the employee is regularly required to sit for long periods of time; stand and walk; use hands to finger, handle or feel; reach with hands and arms.
• This position requires a virtual home-office environment, working remotely and will require that employees be on camera for all virtual meetings.
• The role routinely uses standard office equipment such as computers and mobile devices.
• Travel up to 20% is required to support OCHIN's business requirements which may require travel by air, vehicle, or train.

COVID-19 Vaccination Requirement

To keep our colleagues, members, and communities safe, OCHIN requires all employees-including remote employees, contractors, interns, and new hires-to be vaccinated with a COVID-19 vaccine, as supported by state and federal public health officials, as a condition of employment. All new hires are required to provide proof of full vaccination or receive approval for a medical or religious exemption before their hire date.

Work Location and Travel Requirements

OCHIN is a 100% remote organization with no physical corporate office location. Employees work remotely from home and many of our positions also support our member organizations on-site for new software installations. Nationwide travel is determined based on OCHIN business needs. Please inquire during the interview process about travel requirements for this position.

Work from home requirements are:

• Ability to work independently and efficiently from a home office environment
• High Speed Internet Service
• It is a requirement that employees work in a distraction free workplace

We offer a comprehensive range of benefits. See our website for details: https://ochin.org/employment-openings

Equal Opportunity Statement

OCHIN is an equal opportunity employer. We are committed to building a team that represents a variety of backgrounds, perspectives, and skills for the benefit of our staff, our mission, and the communities we serve.

As an equal opportunity and affirmative action employer, OCHIN does not discriminate on the basis of race, ethnicity, sex, gender identity or expression, sexual orientation, religion, marital or civil union status, parental status, age, disability status, veteran status, or any other protected characteristics. All aspects of employment are based on merit, performance, and business needs.

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