Job Summary and Qualifications
- Oversees efforts to ensure a standardized and consistent approach to the implementation, training, management, and measurement of Value-Based Payer Programs across the PSG enterprise.
- Works with comprehensive data sets and a large array of reporting, both internally developed and provided by payer partners, and must be able to quickly analyze information to determine opportunities, needed interventions, and best practices.
- Conducts value-based payer program education.
- Supports all external audit processes and manages internal audit processes.
- Directly oversees the implementation, training, management, and support for include but are not limited to: MACRA/MIPS, 21st Century CURES, Centers for Medicare and Medicaid Innovation (CMMI) projects; Accountable Care Organizations (ACO); Advanced Alternative Payment Models; Medicare Advantage including HEDIS; and commercial payer value programs. Oversight is all PSG employed/managed providers across all PSG service lines with planning and execution support for enterprise CMS VBC-related data submissions (>10,000+ annually) and manages provider and entity (TIN) eligibility for government and other payer programs.
What qualifications you will need:
- EDUCATION: Bachelor’s Degree required
- Previous experience working with the analysis, implementation, and management of government and commercial payer value-based programs such as MACRA/MIPS, Centers for Medicare and Medicaid Innovation (CMMI) projects; Accountable Care Organizations (ACO); Advanced Alternative Payment Models; Medicare Advantage including HEDIS performance; commercial pay for performance programs, Meaningful Use, PQRS, Core Measures, etc. required
- Minimum 3 years’ prior experience supporting enterprise-wide program support and training models
- Intermediate Excel skills and previous exposure to business intelligence and analytics tools (such as Business Objects, MicroStrategy, Tableau, etc)
- Strong working knowledge of provider-based healthcare operations (ambulatory practices and/or hospital-based providers)
- Advanced analytical and problem solving skills with the ability to quickly draw conclusions and make recommendations required
- Strong teamwork skills and comfort working in a highly collaborative environment; this is a high profile and fast paced team
- A comfort, or even preference, for an environment of discovery and uncertainty
- Maintains comprehensive knowledge of payer and regulatory requirements with ability to work effectively under pressure and adapt to changing priorities.
Benefits
HCA Healthcare offers a total rewards package that supports the health, life, career and retirement of our colleagues. The available plans and programs include:
- Comprehensive medical coverage that covers many common services at no cost or for a low copay. Plans include prescription drug and behavioral health coverage as well as free telemedicine services and free AirMed medical transportation.
- Additional options for dental and vision benefits, life and disability coverage, flexible spending accounts, supplemental health protection plans (accident, critical illness, hospital indemnity), auto and home insurance, identity theft protection, legal counseling, long-term care coverage, moving assistance, pet insurance and more.
- Free counseling services and resources for emotional, physical and financial wellbeing
- 401(k) Plan with a 100% match on 3% to 9% of pay (based on years of service)
- Employee Stock Purchase Plan with 10% off HCA Healthcare stock
- Family support through fertility and family building benefits with Progyny and adoption assistance.
- Referral services for child, elder and pet care, home and auto repair, event planning and more
- Consumer discounts through Abenity and Consumer Discounts
- Retirement readiness, rollover assistance services and preferred banking partnerships
- Education assistance (tuition, student loan, certification support, dependent scholarships)
- Colleague recognition program
- Time Away From Work Program (paid time off, paid family leave, long- and short-term disability coverage and leaves of absence)
- Employee Health Assistance Fund that offers free employee-only coverage to full-time and part-time colleagues based on income.
Learn more about Employee Benefits
Physician Services Group is skilled in physician employment, practice and urgent care operations. We are experts in hospitalist integration, and graduate medical education. We lead more than 1,300 physician practices and 170+ urgent care centers. We are HCA Healthcare's graduate medical education leader. We provide direction for over 260 exceptional resident and fellowship programs. We focus on carrying out value-added solutions. These solutions help physicians deliver patient-centered healthcare. We support HCA Healthcare's commitment to the care and improvement of human life.
HCA Healthcare has been recognized as one of the World's Most Ethical Companies® by the Ethisphere Institute more than ten times. In recent years, HCA Healthcare spent an estimated $3.7 billion in cost for the delivery of charitable care, uninsured discounts, and other uncompensated expenses.
"Bricks and mortar do not make a hospital. People do."- Dr. Thomas Frist, Sr.
HCA Healthcare Co-Founder
If you are looking for an opportunity that provides satisfaction and personal growth, we encourage you to apply for our VBC Program Mgr WFH opening. We promptly review all applications. Highly qualified candidates will be contacted for interviews. Unlock the possibilities and apply today!
We are an equal opportunity employer and value diversity at our company. We do not discriminate on the basis of race, religion, color, national origin, gender, sexual orientation, age, marital status, veteran status, or disability status.