DescriptionThis posting will close on August 26th. Applications will be reviewed after the closing date, and interviews will be conducted within the subsequent two-week period.
Position Summary
The Value Based Care and Payment Programs Director is the lead staff for the lead staff coordinating APCA's role in, and management of, the Medicare Shared Savings Program (MSSP), as well as any other Value Based Care programs APCA develops. This role supports development, implementation, evaluation, and continuous improvement of value based care programs and activities. This position works with a number of external stakeholders, including for program compliance and governance, and works with contractors, health center leaders and staff, and APCA staff for program implementation.
This position is responsible for the following: maintaining funding and fiscal accountability, supporting community partnerships, planning and developing new services, and accomplishing goals and objectives set by the ACO Board of Directors and other relevant stakeholder groups. The ACO is comprised of Alaska federally qualified health centers (FQHCs) working towards shared savings.
Essential Duties and Responsibilities include the following:
Other duties may be assigned, as necessary.
Provide Oversight and Management of Value Based Care Programs
- Works closely with the CEO & CPO and Value Based Care stakeholders on the development of the strategic plan, and planning and reporting tools, and is accountable for the implementation and communication of progress toward strategic priorities.
- Drives the VBC programs' vision and cultivates, develops and fosters strong relationships with all stakeholders.
- Leads development and implementation of VBC business plan and all strategies and tactics for achieving its goals and objectives.
- Oversees the administration of all VBC programs and services in accordance with all program, funding, legal, compliance, and regulatory requirements.
- Works closely with other areas of APCA that support VBC development and improvement of clinical and operational metrics and infrastructure development.
- Develops the structures, systems and processes required to support clinical excellence, performance management, and managed care contracting.
- Represents VBC programs in public forums, builds local relationships, including with business coalitions and other community organizations.
- Oversees the launch, implementation, and evaluation of all VBC programs and/or alternative payment models. This could include government sponsored programs (e.g. Medicaid & CMS's Medicare Shared Savings Program), bundled payment arrangements, and/ or commercial insurance products. Use evaluation results to recommend improvements to programs.
- Collaborates with relevant stakeholders to model the financial impact of value-based programs/ models.
- Creates a best practice learning environment with VBC stakeholders to improve clinical quality, data systems, and operational workflows across and among participating health centers.
- Works closely with BOD and Committee chairs to prepare for, coordinate, and follow up on Board, Committee, and Annual Meetings. This includes the development of agendas, materials, and follow-up actions.
- Serves as the primary liaison with VBC administrative & program services contractors to support business and administrative continuity and manage day-to-day administrative requirements, including a master services agreement (MSA), where appropriate. This can include:
- Administrative Support: i.e. scheduling, logistics, minutes, follow-up
- Data and Programs Support: as needed and identified to support the success of value-based program arrangements and includes staffing of Committees and implementing work plan priorities.
- Oversee the day-to-day work, progress, and activities of VBC contractors.
- Oversee and comply with any necessary reporting requirements. Coordinate with APCA leadership and staff on those reports.
- Analyze performance to meet VBC objectives, strengthen and grow positive results, and identify low result initiatives and strategies to improve or end.
- Serve as a member of APCA's leadership team.
Provide Oversight and Management of VBC Activities with Payers and External Partners
- Leads communication with payers and other partners.
- Work closely with stakeholder groups to analyze and monitor utilization and costs of health care services, improvement and overall quality of care, and overall compliance and performance against programs and contracts with payers.
- Serve as a primary liaison with payers and others contracting with the Network to support VBC payer contracting goals. This includes monitoring and managing provider relations requirements for each payer and coordinating with stakeholder groups on these requirements.
- Serve as the primary liaison with HIT and data partners / vendors to support data and HIT programs, including the implementation of a new data platform (if necessary), and manage the day-to-day functions of these services. This includes coordinating with the Board and the participating FQHCs on these activities and initiating follow-up with data partners / vendors based on direction from the Board and stakeholders.
- Maintain positive business relationships to ensure retention of existing payers, participants, vendors, and other key stakeholders
Lead Participant Relations Functions
- Conduct regular communication including visits with VBC participating health centers; 1) to engage in open face to face dialogue with participants to communicate/educate important issues and updates, 2) ensure effective problem resolution, and 3) to ensure performance compliance with revenue driven initiatives.
- Curate, design, and deliver VBC content, resources, and tools to improve health centers' readiness to participate in VBC.
Program Development and Management
- Procure and manage contracts necessary for VBC program delivery or for special projects
- Special projects are time limited, have focused scopes of work, include program and project development and implementation, and support work in other APCA Departments
- Research, scan, and identify grant and other funding opportunities; write proposals & reports
- Develop and manage grant projects necessary for VBC program delivery or for special projects
- Oversee implementation, tracking, and reporting on the progress of completing the project work plan
- Develop and manage project budgets
Minimum Qualifications and Experience
- Education: Undergraduate degree required from an accredited college or university.
- Experience: At least 5 years of leadership experience in healthcare administration, quality improvement, population health, or other relevant experience
- At least 5 years' experience with program development, grant writing, and program management
- Knowledge of Value Based Care frameworks and Federally Qualified Health Centers.
- Experience managing multiple, large-scale, complex projects.
- Strong skills developing and implementing operating plans and analyzing both financial and quality data.
- In-depth knowledge of the healthcare industry.
- Strong and effective oral, written and conflict management communication skills.
- Demonstrated ability to effectively manage provider relations.
- Ability to manage complex functions and activities and deal with highly sensitive and confidential matters.
Preferred Qualifications and Experience
- Education: Master's degree in business administration or health administration or another related field
- 10 years relevant experience to include Executive Leadership, program management, public health or similar
- FQHC operations experience
- Experience with Alaska's healthcare sector
Skills and Abilities
- Understanding of Alaska populations, Alaska's healthcare systems, as well as the needs and opportunities within Alaska's health care systems and communities.
- Strong project management skills.
- Expertise and experience creating and managing curriculum/instructional design and program development.
- Ability to effectively collaborate with distinct stakeholder groups and partners spanning multiple sectors.
- Ability to work independently and in a collaborative work environment.
- Excellent written and oral communication skills.
- Strong written communication skills: ability to write clear, structured, articulate, and persuasive proposals
- Outcome driven and solution focused.
- Excellent computer and software skills and the ability to learn new software and technical programs easily.
- Ability to work effectively with various types and levels of professionals and organizations
- Ability to exercise discretion, execute independent judgment, and maintain neutrality and confidentiality.
- Ability to effectively and efficiently plan, manage, and delegate work appropriately.
- High degree of initiative, planning, organization, and independent judgment.
- Excellent research, planning, organizational and follow-through skills with high attention to detail
Supervisory Relationship
- Works under the direct supervision of Chief Program Officer. Performance is assessed through review of work, integration, and cooperation within the Department and APCA, communication with all stakeholders, quality and timeliness of deliverables and associated criteria.
Language Skills
Required
- Fluency in written and spoken English required.
- Superior written and oral communication skills.
Travel Required
In-city travel by personal vehicle for meetings, tasks, and errands as needed. In-state and occasional out-of-state travel may occur. Mileage is reimbursed per APCA policy.
Hours per Week
This is a full-time position, 30-40 hours/week. Generally, hours are 8:00 a.m. to 5:00 p.m.
Physical Demands
The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with who require assistance to perform the essential functions.
While performing the duties of this job, the employee is regularly required to sit, talk, and hear, and be able to operate a computer, printer, telephone, computer/projector combination, and photocopier.
Work Environment
Duties will generally be performed in an office setting with travel and associated accommodations throughout the local area, the state of Alaska, and the Lower 48 as needed.
NOTE: Any description of work is a picture of the major responsibilities of a position at a given point in time. Jobs are dynamic and assignments/priorities may change. The primary purpose of this description is to outline and communicate key tasks and expectations for the position. This description does not imply or create a contractual relationship. Alaska Primary Care Association is an at-will employer.
