Director, Global Budget Program-Population Health Management
MedicaidCommercial Employer HealthProduct Development & Plan DesignRisk Management, ERM & ORSABusiness Intelligence & Reporting
Role Summary
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Director-level Health role leading Nemours' Global Budget Program across Delaware Valley and Florida. You will design and scale Medicaid global budget and alternative payment models, oversee actuarial analysis, total cost of care benchmarking, and enterprise financial forecasting. The role combines strategy, payer engagement, governance, and people leadership reporting to the VP, Chief Policy and Prevention Officer in Wilmington, DE.
JOB DESCRIPTION SUMMARY
- Lead system-wide implementation of Medicaid global budget models across two markets
- Design TCOC methodologies and oversee actuarial analysis and financial forecasting
- Engage with state Medicaid agencies, commercial payers, and regulators
- Build and manage the Global Budget Program team and vendor/consultant relationships
- Director role reporting to VP, Chief Policy and Prevention Officer in Wilmington, DE
DOMAIN EXPERTISE
- Financial modeling and enterprise financial forecasting
- Alternative payment model design and implementation
- Risk adjustment methodologies
- Medicaid and payer engagement experience
- Actuarial analysis and total cost of care benchmarking
KEY REQUIREMENTS
- Advanced degree in healthcare management, health policy, economics, or related field
- More than 5 years of relevant experience (enterprise payment models and forecasting)
- Demonstrated expertise in actuarial analysis, risk adjustment, and financial modeling
- Experience engaging with Medicaid agencies and commercial payers
- Proven program leadership with cross-functional and vendor management
TECH STACK
- No tech stack specified
