Analyst Value Based Care

Silver Cross Hospital•New Lenox, IL

1d•Onsite

About The Position

Responsible for analyzing and evaluating all data that is used for Silver Cross Health Connection including but not limited to Medicare Advanced Payment Model, Blue Cross Blue Shield ACO, Medicare Advantage Plans, and any other Managed Care/Value Based Plans. This position will also be responsible for reporting, quality assurance, and putting together presentations to pertinent groups that are involved with Silver Cross Health Connection.

Requirements

5-9 years’ experience in healthcare at commercial payors, hospitals or consulting firms
Bachelor’s degree required
Significant experience contracting and population health programs
Experience with Medicare Advantage
Ability to communicate complex issues/analysis to providers to effectuate change
Ability to work effectively with physician organizations.
Ability to analyze and synthesize large amounts of quantitative and qualitative data.
Demonstrate a high level of proficiency using database applications.

Responsibilities

Develop and expand data reporting library for PHO
Meet with Practices and Physicians
Present findings from financial reports that are created
Evaluate/Understand Value Based Care and various contracting structures that may exist and recommend what would be best for the PHO
Data mine to identify areas of opportunity for the PHO
Support critical Board, Committees, Utilization Management, Finance, and Quality decisions that the PHO need to make.
Implement innovations governmental programs (Medicare, Medicaid, and exchanges) and identify opportunities to pursue innovative ideas.
Develop strategy for utilization management, quality, and risk coding program based on report findings.
Identify ways to offer gain sharing opportunities to network physicians and steps to implement programs.
Position Silver Cross Hospital and Silver Cross PHO as a top Performer and gain access to “first to market opportunities.
Create service area reports that help Admin Director of Value Based Care create overall strategy for network development.
Evaluate opportunities and make recommendations to physicians and senior management
Integrate pricing, contracting and program development strategies to maximize volume and profitability.
Review contracts annually, for PHO, and align strategies to ensure profitability and bonus potential for physicians.
Use employee decision support tools to model and identify opportunities to negotiate improved quality gap closure and risk scoring optimization.