Director of Value Based Healthcare Delivery

The Director of Value Based Care will be responsible for managing professionals contracted to staff the Office of Value Based Health Care Delivery (the Office). The General Assembly mandated the creation of Office to “reduce health-care costs by increasing the availability of high quality, cost-efficient health insurance products with stable, predictable, and affordable rates.”

Essential functions are fundamental, core functions common to all positions in the class series and are not intended to be an exhaustive list of all job duties for any one position in the class. Since class specifications are descriptive and not restrictive, incumbents can complete job duties of similar kind not specifically listed here.

Work of the Office includes, but is not limited to, the following:

•  Establish, implement, and monitor Affordability Standards such as those to increase primary care investment, limit unit price growth for non-professional services, and expand adoption of meaningful alternative payment models.

•  Establish mandatory minimums for payment innovations, including alternative payment models, and evaluate annually whether primary care spending is increasing in compliance with the established mandatory minimums for payment innovations.

•   Collect data and develop annual reports regarding carrier investments in health care, including commercial reimbursement rates for primary and chronic care services, the role of price and utilization in healthcare spending and prescription drug spending as a driver of total cost of care.

•   Monitor and evaluate the percentage of spending in primary care that is delegated to hospitals and related networks for care coordination through alternative payment methods.

•   Evaluate policies and approaches to address provider and payer market consolidation and other market trends.

•   Oversee the activities of Pharmacy Benefit Managers (PBMs), including licensing requirements, ensuring adequate PBM networks, overseeing required reporting by PBMs, and assisting market conduct investigations of PBMs.

JOB REQUIREMENTS for Director of Office of Value Based Healthcare Delivery

Please attach a resume with your online application or use the resume tab in DEL to provide a detailed description of how your education, training and/or experience meets each job requirement including employer, experience/responsibilities, and dates (month/year) of employment/training.

Applicants must have education, training and/or experience demonstrating competence in each of the following areas:

1.  Three years experience in analyzing insurance and financial market trends to make recommendations to management.

2.  Three years experience in interpreting and ensuring compliance with insurance industry laws, rules, regulations, standards, policies, and procedures.

3.  One year experience in program administration such as overseeing and directing the development, implementation and evaluation of programs and services; planning and establishing short and long range program goals and objectives; providing advice to other agency organizational units through consultation.

4.  One year experience in developing policies and procedures.

5.  Six months experience in operations management which includes planning, directing, coordinating, controlling, and evaluating operations typically through subordinate supervisors.

6.  Six months experience in writing and defending proposed legislation and regulations.

 

This posting may be closed on or before 11/23/2022 upon filling the vacant position.

Applicants must be legally authorized to work in the United States. The State of Delaware Executive Branch participates in the Federal E-Verify system where the State will provide the federal government with each new hires Form I-9 information to confirm that you are authorized to work in the U.S. For more information refer to our job seeker resources.

To learn more about the comprehensive benefit package please visit our website at https://dhr.delaware.gov/benefits/

The application and resume are evaluated based upon a rating of your education, training and experience as they relate to the job requirements of the position.  It is essential that you provide complete and accurate information on your application and the supplemental questionnaire to include dates of employment, job title and job duties.  For education and training, list name of educational provider, training course titles and summary of course content.   Narrative information supplied in response to the questions must be supported by the information supplied on the application including your employment, education, and training history as it relates to the job requirements.

Accommodations are available for applicants with disabilities in all phases of the application and employment process.  To request an auxiliary aid or service please call (302) 739-5458. TDD users should call the Delaware Relay Service Number 1-800-232-5460 for assistance.

The State of Delaware is an Equal Opportunity employer and values a diverse workforce. We strongly encourage and seek out a workforce representative of Delaware including race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression.