Job Description
Seeking a Value-Based Care Manager for our Triad locations that include Greensboro, High Point, Winston-Salem, Kernersville, Jamestown, Mt. Airy, and North Wilkesboro, North Carolina. They will work out of our High Point Corporate Office, will report to the COO, and will oversee the existing Value-Based Care Team.
Job Purpose:
The Value-Based Care Manager works with and assists the medical leadership and manages the value-based care team to improve provider performance on QC clinical quality metrics, hierarchical condition category (HCC) coding metrics, utilization and steerage efficiencies, and cost control metrics. This position uses data and reporting on clinical performance for direct-to-provider interventions and strategic improvement, focusing on user experience, education, EMR data, and workflow enhancements, and implementation of enhanced QC knowledge.
ESSENTIAL DUTIES AND RESPONSIBILITIES:
• Uses VBC reporting on HEDIS/STARS quality, HCC/RAF coding, healthcare service cost and utilization, patient steerage patterns, etc., to design and implement innovative performance improvement strategies for practices and providers.
• Collaborates with the medical leadership team to understand barriers to closing quality care gaps and effectively coding for services performed.
• Interprets information from multiple data sources (internal, ACO, and third-party payer) to create a comprehensive performance visualization.
• Applies knowledge of healthcare systems, operations, program design and implementation, technology, and innovation to maximize data impact.
EXPECTATION OF EMPLOYEE:
• Designs and executes strategies that optimize performance in value-based contracts.
• Drive initiatives to improve quality, patient satisfaction, and population health outcomes while managing costs.
• Works well within a team atmosphere, flexible to pivot in approach.
• Demonstrates proficient computer skills, including EMRs.
• Uses strong diligence, advanced problem-solving, and complex reasoning to effectively produce change and demonstrate impact.
• Performs administrative duties as workload necessitates.
• Possesses a working knowledge of healthcare coding (ICD 10, CPT codes, etc.)
• Demonstrates strong knowledge of provider workflows and practice performance.
• Maintains company confidentiality in all areas.
• Possesses a strong knowledge of health care models, including ACOs.
• Uses superior communication skills- speaks effectively in all environments; listens, requests clarification, and responds well to feedback.
• Demonstrates flexible and efficient time management and ability to prioritize workload.
QUALIFICATIONS:
• 5+ years of experience in the healthcare industry; care gap management and/or coding preferred.
• 5+ years of experience collaborating with medical professionals preferred; clinical experience, provider relations, value-based care, etc.
• Organized and initiative-taking.
• Proficient computer skills, including Word and Excel spreadsheets, data entry, electronic medical record (EMR) / Practice Management (PM) systems, and analysis tools.
• Excellent communication skills with the ability to collaborate with physicians, staff, and external organizations.
• Strong phone skills, comfortable with patient engagement
• Strong customer service skills
• Ability to manage multiple tasks/projects simultaneously.
• Comfortable with continuous change and self-initiation
• Use conflict resolution skills when reaching consensus about plans of care and treatment decisions.
• Experience with Value-Based Care programs required.
EDUCATION:
• A bachelor's degree in a related field is required.
• A master's degree is preferred.
BETHANY MEDICAL OFFERS A FULL BENEFITS PACKAGE TO INCLUDE:
• Employee medical/dental/vision insurance. Family coverage is available at a discounted rate.
• Employee Life Insurance
• Generous PTO
• Employee Short-Term Disability
• 401-K with company matching
• Paid Company Holidays.
Job
Type: Full-time
