Value Based Care Representative

Bethany Medical • High Point, NC

4d • Onsite

About The Position

Value-Based Care Representative works with the medical leadership and value-based care team to improve provider performance on QC clinical quality metrics, hierarchical condition category (HCC) coding metrics, utilization and steerage efficiencies, and cost control metrics. This position uses data and reporting on clinical performance for direct-to-provider interventions and strategic improvement, focusing on user experience, education, EMR data, and workflow enhancements, and implementation of enhanced QC knowledge.

Requirements

• 2+ years of experience in the health industry; care gap management and/or coding preferred
• 2+ years of experience working with medical professionals preferred; clinical experience, provider relations, value-based care, etc.
• Organized and self-motivated
• Proficient computer skills, including Word and Excel spreadsheets, data entry, electronic medical record (EMR) / Practice Management (PM) systems, and analysis tools
• Excellent communication skills with the ability to work collaboratively with physicians, staff, and external organizations
• Strong phone skills, comfortable with patient engagement
• Strong customer service skills
• Ability to manage multiple tasks/projects simultaneously
• Comfortable with continuous change and self-initiating
• Use conflict resolution skills when reaching consensus about plans of care and treatment decisions
• Experience with Value-Based Care programs required.

Nice To Haves

• Certified Medical Assistant certificate preferred.
• RNs also welcome to apply

Responsibilities

• Uses VBC reporting on HEDIS/STARS quality, HCC/RAF coding, healthcare service cost and utilization, patient steerage patterns, etc., to design and implement innovative performance improvement strategies for practices and providers.
• Collaborates with the medical leadership team to understand barriers to closing quality care gaps and effectively coding for services performed.
• Interprets information from multiple data sources (internal, ACO, and third-party payer) to create a comprehensive performance visualization.
• Applies knowledge of healthcare systems, operations, program design and implementation, technology, and innovation to maximize data impact.
• Collaborative team-first attitude, transparently sharing ideas and data.
• Works well within a team atmosphere, flexible to pivot in approach
• Demonstrates proficient computer skills, including EMRs
• Uses strong attention to detail, advanced problem-solving, and complex reasoning to effectively produce change and demonstrate impact.
• Performs administrative duties as workload necessitates
• Possess a working knowledge of healthcare coding (ICD 10, CPT codes, etc.)
• Demonstrates strong knowledge of provider workflows and practice performance
• Maintains company confidentiality in all areas
• Possess a strong knowledge of health care models, including ACOs
• Uses superior communication skills- Speaks effectively in all environments; listens, requests clarification, and responds well to feedback.
• Demonstrates flexible and efficient time management and ability to prioritize workload

Benefits

• Employee medical/dental/vision insurance. Family coverage is available at a discounted rate
• Employee Life Insurance
• Generous PTO
• Employee Short Term Disability
• 401-K with company matching
• Paid Company Holidays

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level