Registered Nurse (RN)-Valued Based Care (VBC)-Post Acute Program Manager, , Full-Time, Days

Prisma Health•Columbia, SC

11d•Hybrid

About The Position

The VBC Post Acute Program Manager functions as a core member of the Value Based Care and inVio Health Network team to provide oversight, knowledge, and expertise relative to post-acute partnerships, business unit and programmatic strategy, continuity of care transitions, quality performance indicators, and regulatory compliance. This role aligns closely with Prisma Health’s and inVio Health Network’s value-based care strategy and requires a mix of clinical expertise, operational acumen, leadership skill, and thorough post-acute business understanding across a highly matrixed organization. The position monitors transitions to post-acute resources relative to network quality indicators, participates in performance improvement activities and regularly communicates with senior leaders, physicians, nursing, care coordination, regulatory representatives, and internal and external post-acute agencies that are integral to Prisma Health and inVio Health Network. The position includes oversight of outlined value-based initiatives with post-acute operational leaders in partnership with key stakeholders to include clinical program development, service innovations, and providing education to include competency learning labs. Oversight includes evaluation of processes against defined programmatic goals and identification of operational opportunities, including actions plans as needed for improved program performance.

Requirements

Bachelor's degree in Nursing.
Five (5) years of post-acute care or related experience.
Holds a current RN compact/multistate license recognized by the NCSBN Compact State or is licensed to practice as an RN in the state the team member is working.
Possesses operational or clinical leadership skills in post-acute care industry including quality management/performance improvement experience along with data collection, trending, and analysis, and care management across the continuum of care.
Extensive knowledge of nursing home regulations is required.
Knowledge of related outside regulatory agencies, roles and responsibilities and knowledge of procedures and processes specific to patient care and the principles of performance improvement is required.

Nice To Haves

Nursing Home Administrators License is preferred.
Knowledge of ICD10, CPT, MS DRG and other clinical nomenclature and/or understanding of health care payment (claims payments and/or value-based reimbursements) is preferred.

Responsibilities

Develops partnerships with post-acute care facilities and other providers participating with inVio Health Network and other post-acute facilities as needed, Community Resources, and Prisma Health Hospital and Physician Leadership with a focus on alignment of clinical, operational, and business activities related to these partnerships through in-depth understanding of level-of-care environments.
Communicates and furthers the operational action plan for service based upon the performance strategies of the Post-Acute Care Network to ensure regulatory compliance, quality, collaboration, and patient experience are maximized with each post-acute partner through regular channels of interaction.
Leads the selection of post-acute partners through a formal RFI/RFP process as directed by inVio Health Network leadership. Helps create the RFI/RFP materials, leads the team through the selection process, and serves as a point person for communication with prospective partners.
Develops and utilizes systems to continuously audit, evaluate, and report post-acute composition, performance, and quality improvement to the inVio Health Network Leadership and Committees, Department of Medicine, Mobile Integrated Health, Hospital Care Management, Geriatrics Department, and other appropriate stakeholders utilizing written and verbal articulation of objectives, roles, and initiative outcomes utilizing appropriate data sources.
Rounds routinely in Network facilities and/or meets with agency leadership to review performance metrics provided by inVio Health Network. Serves as a liaison to Prisma Health for any identified opportunities for improvement.
Coordinates and oversees multi-disciplinary team meetings to improve quality through reduced readmission, utilization, and cost.
Escalates issues as needed while appropriately instilling a sense of urgency in completion of assignments with internal and external stakeholders.
Uses business analytics to forecast, strategize, and identify new opportunities in alignment with value-based quality principles.
Organizes and leads periodic Collaboratives with post-acute agencies focused on furthering efficient care transitions, enhanced quality, resource transparency, and education opportunities through use of strong network partner relationships and understanding the interdependencies of care transitions workflows.
Leads the development and delivery of formal educational offerings and learning labs for internal teams and external post-acute agencies in areas identified through collaboration to improve care transitions and quality outcome performance.
Leads cross-functional teams in development, implementation, and operationalization of post-acute programs and processes, including the SNF Care Model program, in support of enhanced performance in key indicators such as utilization, length of stay and readmissions reductions.
Manages operations of cross-functional post-acute projects and innovation initiatives through identifying opportunities, tracking decisions, operationalizing approved innovations, escalating risks, identifying interdependencies, and managing communications to stakeholders.
Performs other duties as assigned.