Manager Value Based Care Performance - Health Plan Admin at CHRISTUS Ministry System Office

Summary:

Manager Value Based Care Performance is charged with supporting teams in solving complex problems focused on improving cost and quality performance on value-based contracts or alternative payment programs. This includes the CHRISTUS Health CIN, Health Plan, and other initiatives as they arise.

Responsibilities:

• Meets expectations of the applicable OneCHRISTUS Competencies: Leader of Self, Leader of Others, or Leader of Leaders.
• Responsible for monitoring, analyzing and synthesizing trends across value-based care contract key indicators and contractual commitments to ensure network performance engaging Network and care management leadership with strategic planning to ensure success in contracts.
• Leads VBC Quality performance monitoring/data submission coordination and data integrity related to clinical quality measures. Serves as thought leader and works with key stakeholders to drive innovation and strategic direction meeting the demands of clinical quality metric performance, interpretation, impact analysis and solutions.
• Assists in monitoring relevant national programs & accreditations such as the Center for Medicare/Medicaid Services (CMS): Merit-Based Incentive Payment System (MIPS) and, National Committee for Quality Assurance, etc. for changes that may impact the organizations measures or programs.
• Consults with care management operations team to integrate solutions within the delivery system and business processes.
• Administrative lead supporting government value-based care programs regulations, requirements, communication and inclusion/removal of employed/affiliated providers.
• Liaisons with managed care contracting and VBC Payers to coordinate new and current risk-based government programs and ACO models.
• Leads operational implementations supporting care management and value based care i.e. Epic, tech integrations, utilization, etc that enable success under risk-based payment models.
• Industry engagement across multiple external organizations. i.e. ACO Vendor Relationship Mgmt.
• Partners effectively with the Health Plan to integrate services driving value and efficiency for the company and VBC stakeholders.
• Manages performance-based incentive programs, identifies opportunities, impact and distribution.
• Creates, develops and provides population health/ACO Education to support CHRISTUS employed or affiliated physician network.
• Supports value-based care performance & strategy and the evolution of product, services, and technology.
• Thinks with an enterprise mindset and to continuously challenges the status quo.
• Motivates people and teams while raising performance levels year over year.
• Quickly recognizes critical areas requiring analysis and review while understanding the big picture.
• Uses communication and presentation skills to handle executive and difficult audiences well, adapting style to audience.
• Manages projects and product development life cycles, specifically in healthcare product design and development to support care management and delivery workflows required.

Job Requirements:

Education/Skills

• Bachelor’s Degree required.
• Demonstrated expertise in Medicare Advantage.

Experience

• 5+ years working with accountable care organization and/or value based care to support performance management of medical costs, quality, and experience required.
• 5+ years of related work experience in a medical clinic, hospital setting, or similar environment required.
• 2+ of supervisory/managerial experience in clinical quality, performance improvement, value based care required.
• Expertise in Medicare Advantage required.
• Experience with MS Office Products – Word, Excel, PowerPoint, visio required.
• Experience with Population Health Management technologies and approaches (e.g., high-risk user stratification tools, cost/quality/utilization trend analysis, provider performance tools) required.
• EPIC EMR experience preferred.

Licenses, Registrations, or Certifications

• None required.

Work Type:

Full Time

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