Director Contract Performance
Company: AmeriHealth Caritas
Posted on: February 14, 2020
Director Contract Performance
Job BriefResponsible for developing systems, and tools to ensure
sustainable improvement on key performance metrics
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
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 www.amerihealthcaritas.com.
The Director Contract Performance reports to the Market President
and is responsible for developing systems, and tools to ensure
sustainable improvement on key performance metrics.
S/he must work closely with business owners across the enterprise
to identify streamline workflows and processes so that they operate
more efficiently and profitably, define reporting requirements, and
initiate projects to improve current state functions that perform
below required levels.
A key function of this role is to implement special projects as
assigned by the Market President and provide a monthly
consolidation of the Plan's operational performance. The incumbent
will be responsible for providing a cross-functional review of key
measurements and performance indicators, and providing business
- Research, collect and confirm key operational measures for DHCF
contract, NCQA, HEDIS, and AOP goal compliance. Works across the
enterprise and with key external stakeholders to develop measures
and operational processes to ensure workflows and processes meet
all contractual, regulatory, and accreditation-based
- Coordinate with Executive staff to develop, communicate and
track progress on the annual and three year strategic/business
- Assist Quality Management and Compliance in preparation and
execution of LOB's audits. To include, organization of
documentation, completion of audit forms, auditing reporting and
management of responses to specific questions from the
- Coordinate the LOB response to contract audits, as well as
ad-hoc data requests. Includes developing presentations, validating
data, and coordinating with cross functional areas to complete and
provide relevant information and other external auditors.
- Organize and facilitate short-term productivity or quality
improvement projects related to operations, and develop clinical
oversight programs focused on reducing unnecessary utilization and
- Partner with business owners and corporate reporting areas to
standardize processes, develop relevant metrics, and design
scorecards highlighting LOB performance in multiple key areas.
- Provide operational oversight and business development
functions in support of the LOBs clinical/medical relationships -
includes attending user meetings, by attending user meetings and
serving as Chief Point of Contact for initiatives and other key
- Coordinate all reporting requests and manage the content of the
ACDC specific reporting library in the Perform Rx portal.
- Create transition plans for moving SWAT processes into
- Bachelor's Degree.
- Eight (8) to ten (10) years of experience.
Keywords: AmeriHealth Caritas, Newark , Director Contract Performance, Executive , Newark, Delaware
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