Program Manager Health Economics Value-Based Care- Health Plan

Parkland Health & Hospital System • Dallas, TX

82d • Hybrid

About The Position

Parkland Community Health Plan's (PCHP's) Health Economics Program Manager monitors cost trends, identifies performance improvement opportunities and develops strategies to support value-based care contracting initiatives across PCHP's health plan networks. Develops contract pricing models, contract performance models, key performance indicators/metrics and other ad hoc analyses to support continuous network development and performance improvement.

Requirements

• Bachelor's degree in Business Administration, Healthcare Administration, Healthcare Analytics, Finance, Statistics or a related field.
• Four (4) years of experience in a health plan or Medicaid Managed Care Organization.
• Two (2) years of experience in medical/health economics, and network decision support.
• Knowledge of managed care contracts and principles and concepts of statistical analysis.
• Demonstrated skill in complex modeling, pro forma, projections and metric reporting.
• Demonstrated ability to support and develop performance improvement strategies.
• Excellent verbal and written communication skills including the ability to influence, negotiate and interact effectively with a range of business stakeholders.
• Strong interpersonal and conflict resolution skills with the ability to establish and maintain effective working relationships across and beyond the organization.
• Excellent analytical and problem-solving skills.
• Strong time management and organizational skills with the ability to manage multiple demands and respond to rapidly changing priorities.
• Ability to write clearly and succinctly with a high level of attention to detail.
• Proficient computer and Microsoft Office skills.
• Ability to learn new software programs.

Nice To Haves

• Master's degree in a related field is preferred.
• Experience with value based/accountable care data analytics is preferred.
• Six Sigma or Project Management certification is preferred.
• Knowledge of Texas Medicaid, National Committee for Quality Assurance (NCQA), the Uniformed Managed Care Contract, and the Uniform Managed Care Manual is preferred.

Responsibilities

• Develops standardized and ad-hoc models to support contract pricing and contract and network performance.
• Develops actionable data driven recommendations and supports the strategic decision-making process.
• Prepares, supports, and presents materials for the contract negotiation process.
• Supports and facilitates health plan budgeting, forecasting and cost-containment initiatives.
• Supports and facilitates new product and new network development initiatives.
• Develops and maintains the library of management information reports to support Network Development and Provider Relations.
• Monitors cost trends.
• Identifies performance improvement opportunities and facilitates initiatives, both internally and externally.
• Creates and implements performance improvement initiatives for PCHP.
• Develops and maintains key performance indicators and performance measurement reports.
• Integrates health literacy principles into all communication including Members and Providers.
• Supports strategies that meet clinical, quality and network improvement goals.
• Promotes the use of Health Information Technology to support and monitor the effectiveness of health and social interventions and make data-driven recommendations as needed.
• For staff in clinical roles, fosters collaborative relationships with members and/or providers to promote and support evidence-based practices and care coordination.
• Ensures work is carried out in compliance with regulatory and/or accreditation standards as well as contractual requirements.
• Promotes and supports a culturally welcoming and inclusive work environment.
• Acts with the highest integrity and ethical standards while adhering to Parkland's Mission, Vision, and Values.
• Adheres to organizational policies, procedures, and guidelines.
• Completes assigned training, self-appraisal, and annual health requirements timely.
• Adheres to hybrid work schedule requirements.
• Attends required meetings and town halls.
• Recognizes and communicates ethical and legal concerns through the established channels of communication.
• Demonstrates accountability and responsibility by independently completing work, including projects and assignments on time, and providing timely responses to requests for information.
• Maintains confidentiality at all times.
• Performs other work as requested that is reasonably related to the employee's position, qualifications, and competencies.

What This Job Offers

• Industry: Hospitals