In order to apply for a position at Lumeris, you must create an account using your email address and a password of your choosing. This account will allow you to receive notifications each step of the way through the job application process. With these updates, you’ll never have to wonder where you are in the process. Additionally, we can easily send pertinent documents to you for your review. Once you create the account, you may apply to any position you feel is a good fit without having to re-enter information. Thank you for your interest in Lumeris. **Position:** Underwriting Director **Position Summary:** Responsible for consulting with external partners on the planning, direction, and implementation of payer relationships and provides expertise on modeling, negotiating, and executing value-based contracts. Utilizes a deep marketplace expertise to serve as a strategic thought partner to adjust strategies and meet high standards of contract development, contract language, drafting, data review, and negotiation. Participates in the development of strategies and methodologies as it relates to Lumeris partnerships. **Job Description:** **Primary Responsibilities** + Prepares, reviews, and presents value-based strategies and financial models across all lines of business, including CMS value based financial models, as they apply to various provider and or health plan settings (i.e., health care systems, health plans, integrated delivery systems, CINs, etc.) + Understands optimal value based managed care contracting and economic terms and develops strategic recommendations for our client partners, supporting their contract negotiation process to advance their opportunities in value-based care. + Creates various innovative financial model scenarios grounded with deep understanding and solid interpretation all value-based payment models including CMS programs, rules, and regulations. + Plays a key role in supporting the continued identification of ways our partners can expand their current CMS value arrangements or develop new CMS value models thereby continually enhancing the value we bring to our current partners as well as supporting new sales opportunities. + Presents complex value based financial models, including CMS models, internally and with our client partners to gain shared understanding of the key economic levers within the CMS rules and how those are evidenced in the financial model executive summary. + Creates value-based care strategies, financial models, and proformas according to the payer's or other risk-bearing entity's proposal, in support of current clients or prospective Lumeris partnerships. + Uses the value-based models to support our clients' negotiations based on proposals and counterproposals, showing the financial impact to an overall contract. + Serves as subject matter expert on value-based contract levers such as risk scores, medical cost trends, revenue trends, and quality performance. + Identifies and recommends opportunities for all forms of value-based contract performance improvement with existing customer contracts. + Collaborates with cross-functional teams to develop solutions, gain alignment, and deliver impactful business insights. Engages with necessary internal business partners to enable strategic direction. + Influences and educates various external and internal business partners on contracting strategies, marketplace dynamics, customer insights, patient healthcare trends, portfolio considerations, communities of practice, and payer payment innovations. + Educates external and internal business partners on market movement that influence and impact work including current and proposed government policy, reimbursement landscape, payer trends, distribution dynamics, and legal considerations. + Shares insights to elevate team-thinking and promote a balanced, holistic point of view around the movement to fee-for-value strategies. Effectively weighs and communicates trade-off considerations. + Addresses complex, strategic business issues and completes work that has significant business impact. **Qualifications** + Bachelor's Degree or equivalent + 15+ years of relevant experience in managed care or the knowledge, skills, and abilities to succeed in the role + Advanced knowledge and ample experience in managed care contracting with a broad range of providers + Comprehensive knowledge of and experience in value-based care and risk-based contracting + Excellent project management skills with the proven ability to yield results + Expert knowledge of provider contracting/negotiations, network development and configuration, standards for value-based contracting, and managed care delivery + Substantive knowledge of population health, value-based care, and managed care policy and direction + Strong communication and negotiation skills + Demonstrated executive presence with the ability to influence at all levels internally and externally Preferred + Bachelor's degree in managed health care, legal, or finance discipline **Working Conditions** + While performing the duties of this job, the employee works in normal office working conditions. **Disclaimer** + The job description describes the general nature and level of work being performed by people assigned to this job and is not intended to be an exhaustive list of all responsibilities, duties and skills required. The physical activities, demands and working conditions represent those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential job duties and responsibilities. \#LI-Remote Lumeris is an EEO/AA employer M/F/V/D. The hiring range for this position is: $133,200.00-$180,900.00 Factors that may be used to determine your actual pay rate include your specific skills, experience, qualifications, location, and comparison to other employees already in this role. This role may also be eligible for incentive compensation. At Lumeris, we are committed to providing a total rewards package that supports your overall well-being. Our benefits include medical, vision, dental, well-being programs, 401(k) with company matching, life insurance, paid time off including paid leave, and so much more. Learn more by visiting our Careers Page (https://www.lumeris.com/healthcare-consulting-careers/) . **Member Facing Position:** No- Not Member or Patient Facing Position **Location:** Remote, USA **Time Type:** Full time **Lumeris and its partners are committed to protecting our high-risk members & prospects when conducting business in-person. All personnel who interact with at-risk members or prospects are required to have completed, at a minimum, the initial series of an approved COVID-19 vaccine. If this role has been identified as member-facing, proof of vaccination will be required as a condition of employment.** **Join Our Growing Team!** Lumeris is bringing common sense back to the business of healthcare by empowering value-based care. We create the partnerships and perspectives that are making healthcare safer, more affordable and more personalized for providers, patients and payers alike. We were founded on the belief that it should be easier to provide the right care, at the right time, at the right cost. Our model is bringing that belief to life, improving outcomes and empowering financial sustainability along the way. **Why Join Lumeris?** At Lumeris, you will be part of team that is focused on solving the nation’s healthcare problem, and you will be able to contribute to our purpose. Our environment is fast-paced, change-oriented and focused on growth and employee engagement. At Lumeris, we know that talent is best utilized when given the opportunity to succeed. That is why we have removed the boundaries that inhibit success and focus on fostering an environment that allows employees to utilize their talents.