Position Summary: Oversee the organizational performance for analytics and population health financial management for the company. Lead the identification and sizing of clinical opportunities, assessment of the effectiveness of programs targeting those opportunities and partner across VCP and with clients to develop and deploy improvement and innovation programs. Direct the development, analysis and improvement of quality metrics, scorecards and profiles for the VCP clinical integration program. Research and analyze medical costs and utilization. Responsible for oversight of the organization’s budget/financialreporting. Manage relationships with Crimson and/or identified data platform team, and oversee payer relationships to ensure that issues are resolved.
- Provide leadership and direction to analytics team. Work cooperatively with other VCP directors and staff to drive the mission of clinical integration across the network.
- Translate highly complex, multi-dimensional healthcare industry information from both internal and external sources, and provide relevant business guidance as a member of the VCP leadership team.
- Supervise the development, analysis and improvement of provider and contract specific reports and scorecards to assess performance across quality, cost and utilization metrics to support performance visibility and tracking.
- Analyze and interpret clinical quality, cost and utilization data. Work with the CI Leadership team to identify actionable opportunities to improve medical cost and quality of our contracted covered lives
- Serve as subject matter expert for VCP’s population health tools and clinical quality databases. Manage analysts who retrieve and disseminate reports, validating for completeness and accuracy.
- Manage relationships with the external data platform team and other IT resources. Serve as the primary liaison for data concerns and needs when identified.
- Leverage performance data as the basis for pay-for-performance, tiered networks and/or narrow networkcontract negotiations.
- Prepare annual operating budget and monthly financialreports.
- Prepare incentive calculations and distribution payments to network providers per the approved annual distribution methodology/plan.
- Attend and participate in monthly Board meetings. Assume administrative responsibility for Performance Committee.
- Continually update, share and demonstrate knowledge of best-demonstrated practices for clinical quality process design, evaluation, measurement and improvement.
- 10+ years experience in health administration, health insurance, medical economics, population health, or related field, with proven effective leadership qualities.
- 5-8years experience in analytics, quality management or informatics, with some focus on physician practice performance data.
- Exceptional critical thinking and problem-solving skills, with an unyielding attention to detail.
- Experience with database tools, predictive modeling and risk stratification process and/or software. Demonstrated knowledge of variance analysis, research, performance tracking, statistical process control analysis or other directly related clinical analysis/decision support techniques.
- Demonstrable knowledge of physician compensation plans, incentives and contracting arrangements.
- Experience with MS Office software in general, with advanced skills in Excel and PowerPoint. MS Project and Access experiencepreferred.
- Passionate about improving the healthcare system.
Preference shown, but not required:
- MBA, MHA, or master’s degree in associated field.
- Graduate of an accredited school of nursing or program in nursing informatics.
- Superior prioritization, organizational, and project management skills.
- Clear and confident communicator.
- Ability to juggle priorities rapidly, re-prioritize, adapt to change, work well under pressure in an entrepreneurial environment, and manage a project from start to finish.
A deep working knowledge of managed care, health system economics and revenue streams, benefit design and risk adjustment. Previous experience with data extraction from clinical information systems including, but not limited to, data warehouses and financial, claims, billing, coding and HIM systems
Job Code: 26479-39518