Manager, Value Based Care Program Operations
About The Position
US Health Partners (“USHP”) seeks to redefine high-quality specialty care in the United States and establish a high-performing, technology-enabled care delivery platform. USHP is partnering with the country’s leading physicians to build a comprehensive, out-patient focused specialty care network targeting the nation’s cardiovascular concerns. Our physician-led organization is passionate about supporting exceptional care and enriching the lives of patients across the United States. We envision the opportunity to create a scaled, cutting-edge, technology-enabled healthcare services platform that leverages a value-based delivery model. The Manager, VBC Program Operations acts as an operational and subject matter expert to the USHP Value Based Care (VBC) and Operations team across the company. The Manager is responsible for creating operational processes to succeed in VBC outcomes, such as mapping out technology needs and enhancements, partnering with ACO and other VBC partners, and identifying and establishing tactics and workflows with providers and operations team. The Manager will be responsible for coordinating program operations and VBC performance improvement efforts for Medicare, Medicare Advantage, and Commercial VBC programs.
Requirements
- Bachelor’s degree required; RN or clinical background preferred
- Strong understanding of ambulatory clinical operations and VBC programs
- 5+ years of experience working in health plans, health systems, or provider organizations, managing value-based and risk-based contracts required
- Analytical, quantitative, and metrics driven; must know how to interpret value-based program requirements and understand the impact on financial results
- Strong project manager able to juggle multiple projects and urgent deliverables across a wide variety of teams and stakeholders
- Must comply with HIPAA rules and regulations
- Must have experience with MSSP ACO, ACO REACH, or Medicare Advantage programs.
Responsibilities
- Function as a subject matter expert on each VBC contract and build operational strategy on key opportunity areas by understanding the details of USHP’s VBC payer contracts and the performance outcomes they require for success
- Responsible for monitoring, analyzing and synthesizing trends across value-based care contract key indicators and contractual commitments to ensure USHP performance
- Leads VBC Quality performance monitoring/data submission coordination and data integrity related to clinical quality measures.
- Design workflows to meet contract measures and partner with internal operational and clinical teams to implement them, including building process documentation for population management, risk adjustment and quality measures
- Work closely with providers and clinical leaders to review population health training, initiatives, and data, along with co-leading provider engagement as needed
- Administrative lead supporting government value-based care programs regulations, requirements, communication, attribution and provider roster management
- Collaborate with external ACO partners on strategies for VBC contracts
- Manage and support relationships between internal partners and facilitate best practice sharing
- Work with teams across USHP to support key processes or areas of improvement
- Working knowledge of EHR quality and population health management programs
- Perform other duties as assigned
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What This Job Offers
Job Type
Full-time
Career Level
Manager
