Mgr Value-Based Care Program

Facility: WCO - Wellstar Corporate Office

Job Summary:

Under the direction of the Executive Director, CIN, the Value-Based Care Program Manager will act as the administrative operations lead for Value-Based Care (VBC) programs with special emphasis on Centers for Medicare & Medicaid Services (CMS) and Center for Medicare and Medicaid Innovation (CMMI) programs. This includes development and maintenance of tracking tools, project plans, and status reports; as well as, responsibility for data analysis, collection, submission and research. The individual in this role is expected to incorporate continuous process improvement into daily work using critical thinking and problem-solving skills to identify opportunities for improvement while promoting engagement of stakeholders in solution development.
The Value-Based Care Program Manager will be responsible for ongoing day to day administrative management and programmatic maintenance of VBC program functions. This position will serve as a liaison between the Executive Sponsors and functional teams such as Population health, Wellstar Clinical Partners, Quality, and other teams informing of any programmatic or policy changes. This position will manage vendor relationships supporting any VBC program.
The Value-Based Care Program Manager will design and develop approaches to projects that ensure each project's strategic direction are in alignment with Wellstar business objectives coordinating with Population Health, Wellstar Clinical Partners, Quality, Managed Care, Medical Group, Finance, Information Technology (IT), Informatics as needed, and will be responsible for maintaining direction and meeting key milestones and timelines.
The individual in this role is expected to incorporate continuous process improvement into daily work using critical thinking and problem-solving skills to identify opportunities for improvement while promoting engagement of stakeholders in solution development. Excellent time management, organizational, and communication skills are essential to this position.

Core Responsibilities and Essential Functions:

Administrative:
* Manage, coordinate and facilitate progress of Wellstar Clinical Partners Medicare Accountable Care Organization (WCP MACO) or other VBC programs related to planning, governance, quality, budget, risk identification, issue resolution, scope management, IT/data needs, time management, and milestone completion.
* Participate in CMS and vendor webinars and communicate learnings to appropriate stakeholders.
* Become the subject matter expert of all CMS rule changes and ensure all necessary parties are informed.
* Develop deliverables for Wellstar Clinical Partners (WCP) Board of Managers Meetings as needed.
* Attend WCP Board of Managers Meetings and select required Committee meetings as needed.
* Manage and maintain CMS's Accountable Care Organization Management System (ACOMS) Portal.
Operations:
* Track any provider network issues.
* Communicate CMS rule changes to appropriate stakeholders.
* Assess new and current CMS VBC programs (e.g. Transforming Episode Accountability Model, Enhancing Oncology Model, Comprehensive Kidney Care Contracting, Realizing Equity, Access, and Community Health, etc.) providing summaries, participation analysis, and needed recommendations.
* Obtain any required approval by CMS for specific activities requiring such approval, such as, but not limited to, the use of marketing materials for ACO Beneficiaries.
* Oversee ACO (or other program) beneficiary notification, compliance adherence, and update ACO (or other program) website as required by CMS.
* Work with Population Health and/or other departments as needed to develop standard and ad hoc reports, Key Performance Indicator (KPIs), dashboards, etc. across multiple functions for any applicable VBC program.
Communications:
* Partner with stakeholders to generate CMS and other VBC program communications.
* Manage distribution lists for needed communications.
* Attend events to promote participation in WCP networks as needed.
* Generate and disseminate all ad hoc communications related to programmatic issues (i.e. incentive payments, quality requirements, regulatory mandates etc.).
Financial:
* Track CMS and other VBC program expenditures and revenues.
* Coordinate with Medical Economics the calculation for the distribution of any shared savings or other VBC payment, including but not limited to all VBC programs.
* Partner with financial planning, WCP, and Population Health to develop annual operating budget.
Performs other duties as assigned
Complies with all Wellstar Health System policies, standards of work, and code of conduct.

Required Minimum Education:

• Bachelors Other or Masters Health Administration-Preferred or Masters Business Administration/Management-Preferred

Required Minimum License(s) and Certification(s):

All certifications are required upon hire unless otherwise stated.

Additional License(s) and Certification(s):

Required Minimum Experience:

Minimum 5 years Program Management experience working within value-based care programs, ACOs, CINs, provider networks, contracting or managed care operations. Required

Required Minimum Skills:

Excellent written and oral communication and presentation skills. High
Critical thinking skills. High
Ability to work with associates at all levels across various departments within a highly matrixed organization. High
Exceptional management ability regarding the design and implementation of processes. High
Ability to collect and analyze information and data to develop short and long term goals. High
Ability to work independently and motivate and develop staff. High