Role Summary

HIGHLIGHTS

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