Associate Director, Innovation
The CAQH CORE Associate Director, Innovation identifies trends, potential partnership opportunities, market strategies and new business options across the CORE initiative. A successful CAQH CORE Associate Director must possess a unique blend of research and data analysis skills; a strategic mindset, and product implementation experience to translate findings into concrete expanded business opportunities across all CAQH CORE business areas.
CAQH CORE Innovation will focus on researching industry and related events, publications and announcements; track industry thought leadership; estimate potential partnership needs and goals; and work with business owners to help establish growth estimates across all existing and potential CAQH CORE business areas.
In conjunction with other Associate Directors, the Associate Director, Innovation, will lead the identification and definition of potential new business opportunities and meaningful expansion of existing. To manage this pipeline development, the Associate Director, Innovations will also collaborate on the drafting of CAQH CORE strategic plans and associated deliverables. The proposed new opportunities and strategic plans will be presented to the CORE Director for consideration. The CORE Associate Director, Innovation reports to the CAQH CORE Director; the position is full time, exempt. RESPONSIBILITIES: - Lead day to day activities of CAQH CORE new business development.
- For new opportunities, identify, manage, create, review and present pertinent data analyses and trending from both internal and external sources.
- Partner with team members to establish growth estimates and work to increase growth and development across all CAQH CORE business areas.
- Provide in-depth research and knowledge of competitive organizations and associated work products.
- Use research and trending findings to create a consolidated pipeline of potential new CORE products and collaborate with identified product owners to take selected potential products live. Products may include new operating rules, Certification product expansion, education/thought leadership and others as appropriate/feasible.
- Grow CAQH CORE relationships with key industry partners.
- Help strengthen and maintain existing CAQH CORE relationships and foster new ones by exploring potential strategic partnerships and/or other opportunities across all CAQH CORE business areas.
- Convene and lead Advisory and/or Subgroups related to new business development.
- Articulate our value proposition so that it empowers current and prospective CAQH CORE Participants to galvanize support for our mission and vision within their respective organization.
- Attend heath care conferences and/or other meetings as appropriate with intent to source and/or reinforce partnership opportunities.
- Work internally to foster mutually beneficial working relationships with CAQH Solutions as appropriate.
- Drive future work efforts and adoption.
- Develop criteria that will help the CORE participants and the market at-large coalesce around new CORE opportunities including those that may be considered for federal mandate given COREs role as the designed HHS operating rule author.
- In collaboration with area owners, formulate and implement strategic development plans for existing CAQH CORE business areas, as well as new/evolved lines of business that can help generate revenue or increase CAQH CORE’s influence within the industry.
- Provide to CAQH CORE Director new business recommendations and prioritization based on strategic fit, buy-in from existing CORE business owners, and financial considerations consistent with the strategic direction of CAQH.
- Ensure consistent and high quality work products.
- Work with other Associate Directors/staff to drive preparation of materials to support respective internal and external discussions.
- Effectively manage CAQH contracted consultants (within allocated budget). Collaborate with the consultants to identify and document potential technical implementation issues and possible solutions in preparation for review by CAQH CORE leadership.
- Coordinate with CORE Project Assistant to ensure scheduling and logistical support are operating efficiently and are in sync with all other aspects of CAQH CORE.
- Other duties as assigned.
KNOWLEDGE, SKILLS AND ABILITIES: - Strong understanding of and experience in the business-to-business side of healthcare, including emerging value-based payment models.
- Extensive background in healthcare billing and payment processes and the revenue cycle.
- Problem solver with a commitment to creating high quality deliverables under tight deadlines.
- Ability to set and manage priorities and drive collaborative agendas.
- Excellent writing and editing skills. Ability to write about complex issues clearly and concisely and strong documentation skills.
- Proven ability to motivate in a team-oriented, time-pressured environment.
- Ability to plan, organize and effectively present concepts.
- Skilled in organizing the evaluation of information from a variety of sources in order to create fact-based recommendations.
- Proactive nature with desire to influence through action.
- Willingness and ability to manage ad hoc project teams comprised of staff, volunteers and consultants often representing divergent views.
- Prior and in-depth knowledge of HIPAA transaction standards preferred.
- Ability to simultaneously manage multiple assignments and create comprehensive work plans.
- Excellent interpersonal communication and conflict resolution skills.
- Attention to detail is a critical requirement. SUPERVISORY RESPONSIBILITY: - Consultants, as relevant and appropriate. EXPERIENCE: - Eight or more years in the healthcare industry, preferably in health plan business development or healthcare management consulting, with experience in developing, launching and sustaining healthcare industry products/programs.
- Substantive experience coordinating multiple initiatives on a national scale. EDUCATION: - Bachelor’s degree required.
- Master’s degree preferred.
- Degrees in business, healthcare administration or health technology disciplines preferred.