Program Manager, Population Health & Vbc

Career opportunities at VillageMD and our operating companies
We're a physician-led, patient-centric network committed to simplifying the complexities of health care and bringing a more connected kind of care.
And now we're proud to say we're part of the VillageMD family.
VillageMD, through its operating companies, provides high-quality, accessible health care services for individuals and communities across the United States, with primary, multispecialty, and urgent care providers serving patients in traditional practice settings, in patients' homes and online appointments.
Committed to serving all patients and working with all payers, VillageMD consistently innovates value-based care, bringing integrated applications, population insights and staffing expertise to its owned and affiliated practices, ensuring high-quality care, better patient outcomes and a reduction in the total cost of care. Through Village Medical, Village Medical at Home, Summit Health, CityMD, Starling Physicians, Westmed, and other practices, VillageMD serves millions of patients throughout their lives, wherever and whenever they need care. Its dedicated workforce of more than 20,000 operates from 770 practice locations and 26 markets.
Why become a Villager?
When you work at VillageMD, or a VillageMD operating company, you are part of a compassionate community of people who work hard every day to make health care better for all. What makes us different is our village of supportive and inspiring peers who want a meaningful career with impact. The work we do is changing the lives of our patients, our communities, and each other. Together, we are creating better outcomes for all.
We're reimagining health care with a primary care-led, value-based care model. Here, you will be part of a team delivering the care we want to see in the world. It is what drives us to knock down old barriers in health care because every patient, every person and every community deserves better care. Here, you will be at the center of our mission. Your voice will be heard, and you will feel empowered to do what's best and right for our patients, communities, and each other. To learn more about VillageMD visit our corporate site VillageMD.com.
Job Description
Position Summary:
The main role of the Population Health/Value Based Care Manager will be to work with clinical and operational leaders across Summit Health to advance value-based care clinical initiatives.
The Manager focuses on current and new initiatives to integrate clinical innovation, transformation and operations. This individual will review, analyze, and evaluate the business needs and will serve as the liaison between clinical and Health Plan teams to help facilitate decisions and actions.
He/she is responsible for creating and refining clinical, business and organizational requirements, and will work closely with internal team members, stakeholders, and collaborators to ensure that projects are conducted in a timely manner in order to achieve goals within defined budgets and work plans.
The Manager will plan, implement, and oversee performance improvement plans and activities in support of Population Health/Value Based Care priorities and demonstrates the ability to manage multiple projects.
The Manager will collaborate to integrate clinical analytic, ancillary and operations capabilities to manage patient populations against improvements in the 'Quadruple Aim' of healthcare: better outcomes, lower cost and an improved patient and clinician experience.
As part of a multi-disciplinary team, the Manager will support the performance in value-based contracts, including collaborating across the organization on the design, monitoring and continuous improvement of Population Health management processes that support value-based care outcomes.
As part of this mission, the Manager will help to drive patient and clinician engagement initiatives. The Manager will report to the Director, Value Based Care.
Essential Job functions:
The essential functions of the position include:

• Direct daily activities to design and develop approaches to value-based care projects and/or program strategies that ensure the strategic direction is in line with Summit Health's clinical and business objectives
• Cultivate and maintain relationships across many Summit Health verticals including Quality, Analytics, Pharmacy, Coding, Primary Care, Care Management, Finance, IT, Marketing, Constant Care and Training to ensure value-based care clinical program participation and collaboration
• Provides adjunct analyses of the business and/or clinical processes related to value-based care initiatives in order to inform the project plans and assist the leadership with information to make decisions to move the project to successful implementation
• Deployment and tracking of new clinical Population Health management initiatives
• Measure practice-level performance across operational and utilization metrics, and identify improvement opportunities to drive strong performance under value-based contracts
• Act as the liaison between Health Plans and Summit Health in various areas, inclusive of general contracting requirements, clinical data exchange, quality, risk adjustment, clinical and care management collaborations and other initiatives
• Own the process of monitoring clinical performance in value-based contracts across multiple Health Plans. Summarize clinical performance findings and trends with recommendations for business decisions.
• Develop and maintain current documentation for the value-based programs with various Health Plan partners (policies, program descriptions, business/action plans, etc.)
• Develop and deliver presentations for varying levels of staff up to and including C-suite executives with the end goal of securing buy-in on strategy or operational decisions related to clinical Population Health initiatives
• Understand the clinical and financial aspects of value-based care programs and be comfortable working with all levels of management and staff
• Collaborates across cross-functional teams to develop policies and procedures to support clinical systems, standards of practice, and evidence-based practices
• Serves as an internal resource for expedited problem identification and resolution, provision of project-specific updates, and team interactions and deadlines
• Develops and manages best practices and tools for clinical performance improvement and project plan execution
• Provides daily support and subject matter expertise on value-based care and identifies areas of opportunity for continuous improvement including on-going education and resources as needed
• Continuously update various portals and clinical dashboards to accurately reflect current provider population, demographics and other key performance indicators as determined by Summit Health or Health Plan partners
• Collaborate with and provide subject matter expertise to the Clinical Analytics Team on the development of actionable reports that will maximize the VBC programs' outcomes on all related program metrics, including providing feedback on vendor tools and reports as well as quantitative and qualitative data sets and reports for patient attribution, quality and clinical efficiency metrics, patient experience, care management and provider performance.
• Collaborate with the Training Team on educational materials that will support staff and provider training related to VBC. Present educational sessions to various audiences to enhance knowledge of VBC concepts such as attribution, quality measures, and care management processes.
• Collaborate with Aftercare/Call Center Teams on patient outreach, engagement and scheduling initiatives that are critical to Population Health management workflows, including prioritization, tracking and monitoring, and providing subject matter expertise.
• Monitor and evaluate value-based care program-related communications from CMS and Health Plans, and assess for relevance and impact on Summit Health
• Attend webinars and in-person meetings to stay involved in changes in value-based care programs
• Keep abreast of government reforms and their impact on our various risk programs
• Maintains a working knowledge of Population Health trends in the context of payer strategies, legislation, industry leaders, and health care practices and incorporates best practices into the strategic vision of Summit Health.
• Drive an optimal patient experience through Summit Health processes and services
• Implements and executes programs for onboarding new value-based programs - including but not limited to developing committee and operational structures and accountabilities and ensuring practice readiness for accountable care requirements

General Job functions:

• Demonstrates the mission, vision and values of Summit Health and incorporates into leadership behaviors, practices and decisions.
• Participates, either individually or as a team member, on committees and in special projects
• Performs other related duties as assigned or requested.
• Maintain the highest level of customer service and satisfaction for all areas of responsibility.
• Other job duties as required.

Education:

• Bachelor's Degree Required
• Master's Degree Preferred in a relevant health care or business field

Experience:

• 5+ years of work experience in a healthcare setting preferably with a complex enterprise health care system or large medical group
• ACO Leadership experience highly preferred
• Project Management experience necessary (PMP Certificate not required)

Required Licensure / Certification / Registration:

• Valid Driver's License

Specialized Skills & Knowledge

• Must have a comprehensive knowledge or be resourceful in collecting the information needed around the Affordable Care Act (ACA), Medicare Shared Savings Programs, CMS programs, accountable care organizations, value-based contracting, Population Health management, clinical integration including but not limited to Federal/State regulations, programs, implementation and operations.
• Must possess a personal presence that is characterized by a sense of honesty, integrity and caring with the ability to inspire and motivate others to promote the mission, vision, goals, and values of Summit Health.
• Must possess strong leadership skills and judgement to effectively manage multiple tasks and priorities. Must be able to work concurrently and collaboratively on a variety of tasks/projects in an environment that may be stressful with individuals having diverse personalities and work styles, and with changing deadlines and competing priorities
• Strategic planning, management and execution skills and the demonstrated ability to be successful with large-scale project implementation.
• Superior verbal and written communication skills (in English) to present advisory, persuasive and authoritative recommendations to all levels.
• Ability to interface with and build robust relationships with all levels of an organization's leadership, key stakeholders and decision makers.
• Ability to support a change management and process improvement work environment. Seeks innovative ways to deliver higher value programs and services more efficiently and effectively.
• Ability to define program, process and business objective and scope. Demonstrated proficiency and expertise to identify, evaluate and articulate operational opportunities and risks, business needs and gaps, and understand overall customer and stakeholders' interest.
• Advanced analytics, evaluative and problem-solving skills to serve in an advisory role in inspiring and initiating new ideas, determining strategies in the absence of guidelines, fostering innovative approaches to situations/processes/issues.
• High proficiency in Microsoft Office applications required.

Physical and Mental Requirements and Working Conditions

• Must be able to adapt to frequently changing work priorities and be able to prioritize and balance the requirements of working with multiple teams and projects.
• Must be able to travel extensively to the various sites (inside and outside of New Jersey)
• Ability to perform duties with time limitations with a high degree of accuracy preferred

Total Rewards at VillageMD
Our team members are essential to our mission to reshape healthcare through the power of connection. VillageMD highly values the critical role that health and wellness play in the lives of our team members and their families. Participation in VillageMD's benefit platform includes Medical, Dental, Life, Disability, Vision, FSA coverages and a 401k savings plan.
Equal Opportunity Employer
Our Company provides equal employment opportunities (EEO) to all employees and applicants for employment without regard to, and does not discriminate on the basis of, race, color, religion, creed, gender/sex, sexual orientation, gender identity and expression (including transgender status), national origin, ancestry, citizenship status, age, disability, genetic information, marital status, pregnancy, military status, veteran status, or any other characteristic protected by applicable federal, state, and local laws.
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