In order to apply for a position at Lumeris, you must create an account using your email address and a password of your choosing. This account will allow you to receive notifications each step of the way through the job application process. With these updates, you’ll never have to wonder where you are in the process. Additionally, we can easily send pertinent documents to you for your review. Once you create the account, you may apply to any position you feel is a good fit without having to re-enter information. Thank you for your interest in Lumeris.

Position:

Position Summary:

Job Description:

Primary Responsibilities

• Identifies and recommends opportunities for all forms of value-based contract performance improvement with existing customer contracts.
• Collaborates with cross-functional teams to develop solutions, gain alignment, and deliver impactful business insights. Engages with necessary internal business partners to enable strategic direction.
• Influences and educates various external and internal business partners on contracting strategies, marketplace dynamics, customer insights, patient healthcare trends, portfolio considerations, communities of practice, and payer payment innovations.
• Educates external and internal business partners on market movement that influence and impact work including current and proposed government policy, reimbursement landscape, payer trends, distribution dynamics, and legal considerations.
• Utilizes depth and breadth of contracting and negotiation knowledge to develop and communicate managed care contract execution strategies that support clients moving to fee-for-value types of contracts.
• Designs and implements negotiation strategies for the terms and conditions in value-based contracts.
• Owns and is accountable for project performance, risk management, administration, financial management, and issue resolution for self-identified or assigned projects with significant scope.
• Shares insights to elevate team-thinking and promote a balanced, holistic point of view around the movement to fee-for-value strategies. Effectively weighs and communicates trade-off considerations.
• Addresses complex, strategic business issues and completes work that has significant business impact.
• Develops and provides plan support and contracting guidance as needed.
• Compiles, maintains, and reviews clients value-based contracts and risk contracts portfolio for the purpose of identifying opportunities to improve contract performance and structures.
• Reviews and recommends resolutions of contract barriers, taking into account prevailing local market information.

Qualifications

• Bachelors Degree or equivalent
• 12+ years of relevant experience in managed care or the knowledge, skills, and abilities to succeed in the role
• Advanced knowledge and ample experience in managed care contracting with a broad range of providers
• Comprehensive knowledge of and experience in value-based care and risk-based contracting
• Excellent project management skills with the proven ability to yield results
• Expert knowledge of provider contracting/negotiations, network development and configuration, standards for value-based contracting, and managed care delivery
• Substantive knowledge of population health, value-based care, and managed care policy and direction
• Strong communication and negotiation skills
• Demonstrated executive presence with the ability to influence at all levels internally and externally
• #LI-REMOTE

• Bachelors degree in managed health care, legal, or finance discipline

Working Conditions

• While performing the duties of this job, the employee works in normal office working conditions.

Disclaimer

• The job description describes the general nature and level of work being performed by people assigned to this job and is not intended to be an exhaustive list of all responsibilities, duties and skills required. The physical activities, demands and working conditions represent those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential job duties and responsibilities.

Lumeris is an EEO/AA employer M/F/V/D.

The hiring range for this position is:

Factors that may be used to determine your actual pay rate include your specific skills, experience, qualifications, location, and comparison to other employees already in this role. This role may also be eligible for incentive compensation. At Lumeris, we are committed to providing a total rewards package that supports your overall well-being. Our benefits include medical, vision, dental, well-being programs, 401(k) with company matching, life insurance, paid time off including paid leave, and so much more. Learn more by visiting our Careers Page.

Member Facing Position:

Location:

Time Type:

Lumeris and its partners are committed to protecting our high-risk members & prospects when conducting business in-person. All personnel who interact with at-risk members or prospects are required to have completed, at a minimum, the initial series of an approved COVID-19 vaccine. If this role has been identified as member-facing, proof of vaccination will be required as a condition of employment.