Job SummaryProvides strategic leadership for value-based care initiatives and facilitates collaboration to improve care quality, patient outcomes, and organizational performance.
Responsibilities and Duties- Designs and directs value-based care program in compliance with regulatory requirements
- Develops and refines value-based care models tailored to organizational goals.
- Monitors, interprets, and implements regulatory changes impacting value-based care.
- Coordinates with compliance team and resources to ensure program alignment with current laws and regulations.
- Leads regulatory reporting activities and prepares and maintains documentation.
- Creates and enforces compliance protocols for all facets of the value-based care program and conducts regular compliance audits to address identified gaps.
- Collaborates with quality improvement team to maintain accreditation and regulatory standards.
- Provides compliance training and education to staff.
- Leads value-based care initiatives and facilitates integration into operational workflows.
- Oversees daily operations of value-based care programs, ensuring services are responsive, organized, and focused on improving health outcomes.
- Assesses workflows and makes recommendations to optimize workflows for enhanced care delivery and operational efficiency.
- Establishes process improvement initiatives and tracks operational outcomes.
- Mentors and collaborates with operational leaders and teams for consistent execution of value-based care program objectives.
- Develops revenue strategy and monitors financial performance of value-based care program.
- Designs and implements revenue strategy for value-based care initiatives to achieve financial sustainability.
- Analyzes reimbursement trends and recommends program adjustments to maximize returns.
- Collaborates with finance and analytics teams to monitor program financial performance.
- Creates business plans and reporting for leadership and stakeholders.
- Advances value-based care program through collaboration and stakeholder engagement.
- Collaborates with clinical, administrative, and IT teams to ensure integrated care delivery.
- Engages with external stakeholders, such as payers, regulators, and community partners, and identifies opportunities to advance program objectives.
- Facilitates meetings and communications to drive awareness and adoption of value-based practices.
- Gathers and acts on feedback from patients, families, and staff to promote continuous improvement.
- Provides overall management and direction to departmental staff.
- Oversees the development and maintenance of the departmental budget; monitors ongoing budgetary compliance and addresses problems as needed.
- Delegates departmental duties and responsibilities; participates in high priority special projects and activities.
- Represents the department at all senior management meetings.
- Prepares departmental company policies and procedures and conveys all senior management communications and directives.
- Monitors departmental performance using company performance standards and addresses issues as needed.
- Directs departmental performance and provides specific instructions on completion of tasks/responsibilities.
- Prepares and conducts performance appraisals for immediate staff.
- Conducts hiring, disciplinary, and termination procedures.
Qualifications and SkillsBachelor's Degree in Healthcare Administration, Public Health, Health Informatics, Nursing, Business Administration or related healthcare field. Previous experience with population health, case management, quality performance measures, and value-based care reimbursement models.
