[Hiring] Value Based Care Specialist @MetaRPO

Role Description

As a Manager of Provider Solutions, your role is pivotal in guiding healthcare providers toward achieving optimal outcomes in value-based care, ultimately improving patient health and well-being while managing costs effectively. In developing and implementing strategic initiatives to increase provider readiness from traditional fee-for-service models to value-based care models. Here's an overview of the responsibilities and key skills associated with this role:

• Performance Analysis:
  • Conduct in-depth analysis of contractual performance metrics related to value-based care, including utilization measures, benchmarking, cost-effectiveness, and patient outcomes.
• Data Interpretation:
  • Interpret and translate complex data into actionable insights for healthcare providers, helping them understand and improve their performance.
• Financial Management:
  • Monitor financial performance related to value-based care contracts and identify opportunities for cost savings, risk adjustment and revenue enhancement.
• Patient Engagement:
  • Develop strategies to actively involve patients in their care and treatment plans.
  • Implement patient education programs to promote health and prevent avoidable healthcare utilization.
  • Provide constructive feedback and coaching to healthcare providers, offering guidance on how to enhance their practices to align with value-based care goals.
• Collaboration with Clinical Teams:
  • Collaborate with clinical leaders to integrate value-based care principles into clinical practice, emphasizing preventive care, care coordination, and patient engagement.
  • Collaborate with leadership to establish goals aligned with value-based care principles for initiatives to continuously improve in care delivery, patient satisfaction, and cost-efficiency.
• Care Coordination Optimization:
  • Work with internal and external healthcare teams to improve care coordination efforts, ensuring seamless transitions of care and effective communication among providers.
• Technology Utilization:
  • Evaluate and recommend technology solutions that support value-based care initiatives, including electronic health record (EHR) optimization and other relevant tools.
  • Identify and implement innovative technologies and solutions that support value-based care delivery and improve patient outcomes.
• Educational Support:
  • Develop and deliver training programs to educate healthcare providers and staff on best practices in value-based care delivery.
• Risk Stratification:
  • Assist in the development and implementation of risk stratification models to identify high-risk patients and tailor care interventions accordingly.
• Patient Engagement Strategies:
  • Collaborate on the development of strategies to actively engage patients in their care, promoting preventive measures and improving overall health outcomes.

Qualifications

• Bachelor's degree or commensurate work experience in healthcare administration, public health, or a related field.
• 3-5 years of experience in healthcare change management, provider relations, or a related role.
• In-depth knowledge of healthcare regulations, value-based care, and performance metrics.
• Strong analytical and problem-solving skills, with the ability to interpret complex data sets and identify improvement opportunities.
• Excellent communication and interpersonal skills to collaborate effectively with providers, team members, and stakeholders at all levels.
• Proven experience in designing and delivering training programs or educational initiatives.
• Proficiency in data management and analysis tools, such as Excel or data visualization software.
• Familiarity with electronic health record systems and healthcare information technology.
• Detail-oriented, organized, and able to manage multiple projects simultaneously.
• Ability to work independently, demonstrate initiative, and drive results in a fast-paced environment.
• Position is remote – secure home network required and familiar with Microsoft Office products and VPN.

Requirements

• Six Sigma Green Belt, Licensed Allied Health Professional, or Licensed Registered Nurse preferred.
• Certified Professional in Healthcare Quality (CPHQ) or equivalent preferred.