Value Based Care Performance Manager

CORE RESPONSIBILITIES:

• Develop and implement evidence-based population health strategies that address the needs of diverse patient populations, with a focus on managing chronic conditions and at-risk patients and reducing the demand of secondary, tertiary and post-acute care services.
• Collaborate with executive and physician leadership to establish goals, objectives, and key performance indicators for the program.
• Oversee day-to-day operations of a multidisciplinary team that includes coding educators and clinicians ensuring cohesion across disciplines to achieve program goals. Additionally, partner with other clinical and administrative roles based on specific needs (e.g., clinical pharmacy)
• Provide direct oversite for and collaborate with the Clinical Coding Education Supervisor to update and revise workflows and best practices related to the clinical documentation improvement team and risk adjustment documentation.
• Provides strategic direction for the clinical documentation improvement program in collaboration with the Contracting team and Clinical Coding Education Supervisor, and designs programmatic design to execute defined strategies.
• Foster a culture of continuous improvement, collaboration, and shared accountability.
• Leverage data analytics to risk stratify patients, monitor performance metrics, predict utilization trends, and adjust strategies to optimize outcomes.
• Collaborate closely with the contracting team to understand the terms, commitments, and performance expectations outlined in payer contracts.
• Translate contract requirements into operational plans and workflows for the population health team and collaborate with the Clinical Implementation Specialist to implement quality improvement initiatives aimed at enhancing patient outcomes and reducing unnecessary healthcare utilization.
• Ensure that the team’s initiatives are aligned with contract performance targets, such as quality metrics, cost reduction goals, and risk adjustment.
• Monitor progress toward performance targets, making necessary adjustments to the team's work to meet contractual obligations and optimize value-based care outcomes and 3rd party financial incentives.
• Provide regular updates to Board Committees and management on program performance.
• Leadership Competencies
  • Personnel Management
    • Overall accountability and management of staff
    • Regularly assess developmental opportunities for staff, coach staff to enhance performance, and support staff in learning and applying new skills and competencies.
    • Coordinate and monitor staffing levels and labor efficiency.
    • Approver for staff payroll biweekly in accordance with payroll department guidelines and schedule.
    • Mentors and counsels’ staff to include initiating Performance Improvement plans.
    • Works with the Compliance and Human Resources teams to assure compliance with State, Federal and OSHA (Occupational Safety and Health Administration) requirements for staff.
  • Leadership
    • Models behaviors that demonstrate service excellence to staff and focus on the patient as the primary customer.
    • Leads Lean Six Sigma initiatives for the department to foster a culture of continuous improvement.
    • Fosters intra-departmental support and collaboration between all sites.
    • Monitors department performance and creatively seeks solutions to foster quality improvement.
    • Develop and maintain an open and effective line of communication with employees.
  • Communication
    • Works in partnership with the clinical teams, practice leadership, and senior leadership teams.
    • Fosters strong working relationships with all levels of the organization to facilitate effective communication and to connect front line staff’s daily priorities to the organization’s strategic goals.
    • Demonstrates strong interpersonal savvy.
  • Strategic Planning and Program Coordination
    • Assess current state of department with relation to existing InterMed goals and plans.
    • Develops proactive plans to ensure InterMed’s positioning as a leader in healthcare in alignment with company KPIs.
    • Monitors budgets to identify potential financial overruns and variances; makes appropriate recommendations to alleviate financial implications.
    • Champions interdepartmental problem solving.
    • Ensures appropriate departmental policy development and adherence.
  • Confidentiality
    • Demonstrate knowledge and understanding of patient privacy rights under HIPAA (Health Insurance Portability and Accountability) guidelines. Maintain confidentiality related to financial, or other sensitive materials and information in printed, electronic, or verbal form, which may jeopardize the privacy of patients and/or employees. Accesses and uses the minimum necessary patient identifiable information to perform job responsibilities and duties and only for authorized purposes.
  • Maintains strict confidentiality in alignment with HIPAA (Health Insurance Portability and Accountability) guidelines and InterMed policies.
  • Perform other duties to support the mission, vision and values of InterMed.

MISSION AND VALUES:

• Follows InterMed’s mission to provide patient-centered primary care, putting the patient first to deliver high quality, high value care.
• Provide the highest quality care to our patients with a level of service that exceeds their expectations.
• Maintain a positive attitude and always treat our patients and each other with dignity and respect.
• Insist on honesty and integrity from each other and our business partners.
• Make teamwork a core component of our relationships between physicians, staff, and patients.
• Embrace change to better serve our patients.
• Use business practices that feature individual accountability and group responsibility to ensure delivery of high value healthcare.
• Have fun as we carry out our mission to serve.

KNOWLEDGE, SKILLS, AND ABILITIES:

• Education:
  • Bachelor’s degree in nursing or public health, or related field required.
• Experience:
  • Minimum of 5 years of experience in population health/value-based care, care coordination, or a related field.
  • Experience leading multidisciplinary teams, including clinical professionals.
  • Proven track record of improving clinical outcomes and managing risk in a healthcare setting.
  • Strong leadership and team management abilities.
  • Excellent communication, collaboration, and problem-solving skills.
  • Knowledge of population health management principles, value-based care, and transitional care management.
  • Proficient in data analytics and performance measurement.

InterMed is an equal opportunity workplace and prohibits discrimination or harassment of any kind. We recruit, employ, train, compensate, and promote without regard to race, religion, creed, color, national origin, age, gender, gender identity and/or expression, sexual orientation, marital status, disability, veteran status, or any other basis protected by applicable federal, state or local law.