Director, Health Economics & Policy (Private Payers) - Ohio Hospital Association - COLUMBUS, OH
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Company: Ohio Hospital Association
The Ohio Hospital Association (OHA) was established in 1915 as the first state-level hospital association in the U.S. OHA currently represents 237 hospitals and 13 health systems throughout Ohio. OHA’s mission is to collaborate with member hospitals and health systems to ensure a healthy Ohio.
This position works in the Health Economics & Policy Department. The Director will meet the qualifications listed below and be primarily responsible for leading OHA’s efforts with regard to hospitals’ relations with private payers, including commercial, Medicaid Managed Care, and Medicare Advantage. Other responsibilities are defined below. This position reports directly to the Executive Vice President, Health Economics & Policy.
REPRESENTATIVE DUTIES AND RESPONSIBILITIES:
- Exercise independent judgment and discretion to develop and maintain positive working relationships with key staff at private payers, member hospitals, and regulators with jurisdiction over managed care and insurance matters.
- Serve as primary staff liaison for an OHA member committee that will work to identify and resolve issues of concern for hospitals in their relationships with private payers.
- Convene meetings among OHA members that own and operate payers.
- Facilitate and maintain relationships between OHA President/CEO and CEOs of payers important to Ohio hospitals.
- Convene regional or national meetings with payers that have significant presence in Ohio.
- Coordinate meetings between private payers and hospitals to discuss and resolve issues of concern to hospitals.
- Develop communications and resources for member hospitals with analysis of payment policy changes introduced by private payers, as well as state and federal managed care and insurance market reforms impacting hospitals.
- Coordinate the association’s payer scorecard, including the collection of data, analysis of trends, and presentation of data to both members and payers, as needed.
- Convene cross-departmental teams within OHA to process policy initiatives, advocacy proposals, and other ideas to serve member hospitals in their relations with private payers.
- Serve as primary OHA liaison to the Ohio Department of Insurance.
- In coordination with OHA’s advocacy team, identify and lead advocacy initiatives with administrative/regulatory bodies and the legislature to address policy changes impacting hospital/private payer relations.
- Participate in internal and external work groups and coalitions on initiatives related to hospitals’ relations with private payers.
- Perform other duties, as assigned.
- Bachelor’s degree required; (Advanced degree preferred)
- 10 years or more of experience either: (1) working in a hospital dealing with private payer issues; (2) working for a private payer dealing with hospitals; or (3) working in a health policy or regulatory field requiring expertise in hospital/private payer relations.
- Existing relationship with key decision-makers within private payers (preferred)
- Knowledge of health care industry trends and new developments.
- Knowledge of health plan and hospital operations, including billing and payment systems, managed care contracting, reimbursement, and managed care laws impacting hospitals.
- Strategic thinker with sound judgment and political savvy.
- Ability to work in an open, team environment as well as independently.
- Ability to work simultaneously on several activities and handle multiple demands with efficiency and tact.
- Strong interpersonal and verbal and written communication skills.
- Excellent customer service skills.
- Team player with ability to cultivate effective partnerships within and outside the hospital community.
The Ohio Hospital Association is an equal employment opportunity employer. All qualified applicants will receive consideration for employment without regard to, among other things, race, color, religion, sex, sexual orientation, gender identity, national origin, age, status as a protected veteran, or disability.
A cover letter and resume should be emailed to:
Executive Vice President, Health Economics & Policy
Ohio Hospital Association
155 E. Broad Street, Suite 301
Columbus, OH 43215
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