Manager, Population Health VBP Operations - Somerset, NJ

Qualifications:

Required:

• Bachelors Degree required

• At least 5 years healthcare experience

• At least 2 years of management experience

• Must have a valid NJ driver's license

Preferred:

• 2 years of experience managing ACO

Essential Functions:

• This role involves developing, leading, and supporting various strategies, programs, and initiatives focused on value-based performance in risk-based settings and population health
• Key responsibilities include supporting RWJBH ACO operations, connecting value-based programs with quality reporting and management activities, participating in system-wide strategies for population health, and getting the organization ready to handle risk with a multi-payer ACO approach
• Support ACO Board and ACO committees by leading workgroups and strategic initiatives
• Oversee ACO programs, including performance monitoring, reporting, and compliance. Build and develop workplan to improve the ACO's utilization metrics (i.e. ER/K, IP/K, Avoidable ED), financial metrics/opportunities, quality improvement plan.
• Collaborate with clinical and administrative teams to effectively execute ACO initiatives. Prepare monthly report on the performance improvement and outcome of the initiatives.
• Oversee the payer roster communications and changes submission process for value-based contracts
• Conduct weekly and monthly meetings with government and commercial payers regarding program requirements and submissions of physician's records.
• Conduct monthly meetings with stakeholders within the RWJBH system; with an effort to improve our performance in ACO.
• Utilize government program portals to update and edit provider roster changes through the year
• Attend recurring calls with Medical Group and Joint Venture credentialing to ensure provider alignment in various contracts
• Prepare workflow and process of onboarding practices that join our Clinically Integrated Network.

Other Duties:

Please note this job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee for this job. Duties, responsibilities and activities may change at any time, with or without notice.