Develop Managed Care Strategy across all markets for Baylor Scott and White Health (BSWH). Focus on health services research to keep abreast of changes in technology, clinical care, reimbursement, benefit design, labor trends, demographic trends, mandated benefits, regulatory changes, health and welfare benefits, payment for quality, evidence-based reimbursement, uninsured/underinsured trends. Research accomplished by using primary and secondary research including internet and literature searches, personal interviews, networking, and surveys.
ESSENTIAL FUNCTIONS - Identifies, interprets and implements practices that impact performance of BSWH at the strategic and tactical level. - Conducts market research, employer research, and payor/due diligence research across all BSWH facilities. Research must be location specific based on differing aspects for each market. Generates and leverages information. - Consults with BSWH knowledge managers via clinical council meetings to maximize knowledge sharing that affects system financial performance and system quality performance. - Develops and implements communications plansincluding presentations, reports and newsletters to share market information, outcome data and performance management data withal levels of the organization and external audiences., both internal and external. - Develops and delivers presentations to all levels of the organization and external audiences on topics outlined above. - Develops and disseminates information as related to topics above via electronic and written communication to internal and external communication such as market briefs, newsletters, and reports - Builds and maintains effective customer knowledge relationships, serving as the central point of contact for managed care market knowledge within BSWH. Participates on system-wide clinical councils, town hall meetings, etc. - Meets with managed care payors - Communicates with senior level leadership - Attends local and regional conferences - Coordinates BSWH data and information to respond to Request for Information (RFI) from managed care companies to participate in national specialty networks. - Manages and directs the collection, data warehousing and sharing of large employer health plan information across all BSWH markets.
Baylor Scott & White Health (BSWH) is the largest not-for-profit health care system in Texas and one of the largest in the United States. With a commitment to and a track record of innovation, collaboration, integrity and compassion for the patient, BSWH stands to be one of the nation’s exemplary health care organizations. Our mission is to serve all people by providing personalized health and wellness through exemplary care, education and research as a Christian ministry of healing. Joining our team is not just accepting a job, it’s accepting a calling!