Consultant

• Deliver on the LTSS commitment linking provider payment to improved performance
• Support the design and modification of Anthem Value Based Payment (VBP) based on stakeholder feedback and utilization
• Partner with Ohio Department of Medicaid (ODM), LTSS contractors, and stakeholders to deploy VBP methodologies for home and community-based services and long-term care nursing facility services
• Advise on innovative programming and support VBP offerings
• Responsible for provider training, technical assistance, utilization, and performance monitoring related to VBP
• Work collaboratively with stakeholders to define key VBP performance indicators and deliver program performance to providers
• Establish a core set of measures for provider feedback reports standardized across LTSS Contractors
• Coordinate negotiated contracts for new and existing providers as needed
• Function as a high-level technical resource to resolve or facilitate complex provider issues
• Coordinate Joint Operation Committees (JOC) for larger provider groups and drive meetings
• Identify and report on provider utilization patterns impacting quality of service delivery
• Track and conduct provider refresher training as needed
• Research issues that may impact future provider negotiations or jeopardize network retention
• Travel to worksite and other locations, as necessary

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