- Responsible for providing leadership and direction to ensure the annual quality submissions are integrated according to technical specifications and deadlines
- Creates and presents formal performance reports throughout measurement year to keep Executive management apprised of current status and trend
- Provides continuous training and education to all Provider Groups in Managed Medicare products to improve star rating and risk adjustment performance
- Develops and maintains a detailed project plan to include milestones, tasks, and targets/actual dates of completion for each practice
- Identify opportunities and develops strategies for improved methods to drive Provider Group participation in Managed Care Programs.
- Proactively identifies and communicates issues at risk by making suggestions to the providers and implements mitigation and contingency strategies to promote superior CIN performance.
- Participate in bi-weekly review analysis with vendors to ensure the plan meets contractual targets, employs creative strategies to create and develop new initiatives to increase plan overall start rating and maintain said rating year over year.
- Continuous mindset toward efficiency and process improvement – how to apply technology and processes to improve delivery and efficiency from both the Provider Group and internal perspective
- Proactively identify Provider Group’s needs, resolving and communicating concerns or complaints regarding CIN programs to maintain Provider Group satisfaction.
- Oversee the maintenance of the Performance Advocates database that includes all participating physicians and ancillary providers for the assigned territory
- Professionally always represents the organization; supports the mission, goals, and objectives; participate as a ‘team player”, constantly supporting other staff; sets an example of high personal and professional conduct for employees and others.
- Bachelor’s degree or Registered Nurse or equivalent clinical work experience.
- 1-2 years’ experience in a physician’s office.
- Strong client focus (provide examples of success).
- Value relationships; demonstrate professional respect and innovative mindset.
- Confident working with health care professionals.
- Passionate about your work and move forward with purpose; demonstrate clear value and support of your Provider Groups and internal teams.
- Exercise judgment to problem solve when the answer is not readily apparent.
- Approach problem solving involves systems thinking – understanding how the process works and how your decisions impact people.
- Strong communication skills – understanding the need to be inclusive for effective results; communicate effectively with daily operational resources and executive management.
- Understand a sense of urgency, fast-paced, and multi-tasking environment; strong organizational skills.
- Solutions-oriented, willing to bring Provider Groups results regardless of roles or titles.
- Knowledge of star rating, risk adjustment, EMRs, and clinical measures.
- Requires daily local travel to provider offices. (mileage reimbursement provided)
- Willingness and ability to attend after hour business meetings as needed.
- Must maintain a valid driver’s license and use a personal vehicle for travel.
- Experience with basic Microsoft Office Applications.
Healthcare trailblazer. Top 100 workplace. Fastest growing private company. We’ve been called them all. Here’s one that we’re most proud of: We’re a company that lives our purpose of helping communities thrive.
- Our communities deserve more than the increasingly broken healthcare system we have inherited.
- Innovation must connect the healthcare experience to move people the right way on their health journey.
- Healthcare is better when people are known.
- Those who have earned the most trust will produce the most meaningful change.
Every day, our team works to turn those beliefs into actions that are poised to change the way people think about and receive healthcare. Every day, we support people’s health journeys by authentically living our values: Purpose Driven, Relationships Matter, Serve Others First and Inspire Creativity.
Our inclusive and vibrant culture empowers team members strive, perform and have a lot of fun on the way.
If this connects with you, we’re looking for exceptional talent with a growth mindset … people who are ready to make an impact. We look forward to meeting you!
(if you already have a resume on Indeed)