Value-Based Care Coordinator - Hybrid - Erie

Highmark Health • West Ridge, IL

4d • Hybrid

About The Position

This position works collaboratively with the Clinically Integrated Network and across the continuum of care to support success in value-based reimbursement (VBR) programs and department operations. Submits documentation to payers for VBR programs. Coordinates projects related to achieving departmental goals. Assists department leadership with day to day operations and execution of strategies to optimize performance in value-based programs.

Requirements

• Associates degree or relevant experience and/or education as determined by the company in lieu of Associates degree.
• 1 year of experience in a health care delivery setting, preferable in a clinical role such as a medical assistant.
• 1 year of experience with VBR programs and payer submission process.
• 1 year experience of working independently with minimal supervision and meet project and payer deadlines.
• 1 year of experience with Microsoft Office software (Word, Excel, Access, PowerPoint, etc.).

Nice To Haves

• Certified Medical Assistant (CMA) or Licensed Practical Nurse (LPN)
• 1 year experience with an good understanding of various EMR systems.
• 1 year of experience with VBR programs and payer submission process.
• 1 year of experience with HEDIS/STARs metric specification and documentation requirements.
• 1 year of experience managing large-scale projects preferably in the areas of quality, transformation and CINs.

Responsibilities

• Proactively provide quality chart review and direct submission to payer portals for gap closure.
• Participate in the development of presentations and instructional materials to optimize VBR performance including Performance Summaries for Field Team and Executive Leaders, Practice Resource Binders, Medicare Shared Savings Plan (MSSP) submission tool kit.
• Directly responsible for development and management of value team monthly Practice Reporting templates.
• Assists in the development and implementation of strategies that support value based contract requirements and Clinically Integrated Network (CIN) goals.
• Assists in the development and implementation of population health management strategies including telephonic outreach to patients for gap closure and care coordination.
• Support VBR related initiatives across the continuum of care.
• Other duties as assigned or requested.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: Associate degree