Current Jobs

Job Title Location

Description

Date
Manager, Ambulatory Quality and Population Health Based in Evanston Hospital but opportunity for telecommute or based in Evanston Hospital with flexible schedules

Do you want to be a part of a flourishing healthcare organization that values quality of care, continuous improvement and clinical innovation as well as fostering an environment of collaboration, inclusivity and professional development? Are you a data- and results-driven leader that can deploy multiple cross-functional initiatives to advance care delivery models and population health strategies for our patients? Then please consider applying!

Education/Experience:

  • A minimum of 5 years Health Care related experience with Master’s/PhD OR 5 years of clinical Nursing experience required (MSN preferred); and experience in Quality or Performance Improvement required. Certification
  • Lean/Six Sigma training or certification strongly encouraged

Skills

  • Excellent communication, facilitation, analytical and motivational skills consistent with effective change management and innovation deployment.
  • Must be focused, results driven, and able to collaborate with and lead others; familiarity with data and the understanding of statistical methods.
  • Fluent in process improvement methodologies strong preferred.

License

  • If you are an RN, a current professional Nursing Licensure in the State of IL

What you will do in depth

  • Lead and execute organization-wide performance improvement initiatives of varying sizes by incorporating the use of evidence-based practices and utilizing industry-known tools and methodologies
  • Be responsible for the deployment of population health initiatives to ensure alignment and maximize performance within our value-based care model
  • Act as a change agent and develop strong collaborative relationships with operational leaders and relevant stakeholders across the organization to improve the health outcomes of our patients
  • Play an active role in the development of metrics, data, tools and workflows to monitor key performance indicators and quality improvement outcomes
Apply Now!
06/28/2022
Product Leader- CMS Direct Contracting Indianapolis, IN The Director-Product Leader-CMS Direct Contracting is responsible for leading IU Health Direct Contracting arrangement with CMS as part of IU Health’s value-based care (VBC) strategic pillar. In working across multiple areas of IU Health (e.g., VBC leadership, Managed Care, VBC Risk and Strategic Insights, Population Health, Finance, etc.), the leader will be the single point of contact for all matters related to the CMS Direct Contract program and performance. The leader understands and supports the vision of IU Health’s VBC strategic pillar. The leader will partner with IU Health Managed Care in the analysis, negotiation and contracting for all risk-based arrangements. The leader translates CMS Program requirements into a recommended strategy and plan using their technical knowledge of the CMS Direct Contracting program. The leader partners with various functional leaders from throughout IU Health to implement and execute strategy. The leader is responsible for developing clear, consistent reporting tools and management processes that drive the clinical and economic performance of the various arrangements. This role moves between the deep technical program details and presentations, discussions and other interactions with a cross-functional executive audience.
Apply Now!
06/22/2022
Senior Data Scientist Remote

Under the direction of the Office of Clinical Integration (OCI) Management team, leads the interpretation and program evaluation of performance improvement opportunities through the use of statistical, algorithmic, mining, and visualization techniques. Collaborates at all levels of the organization to accomplish the value-based program goals and UMass Memorial Health Care strategic goals and objectives.

Major Responsibilities

  1. Serves as project leader for Population Health analytics projects by working closely to turn data into critical information/knowledge that can be used to make sound organizational decisions.
  2. Mentors Data Scientists in the development of process improvement and evaluation opportunities to increase the efficiency of the reporting process. Applies advanced statistical and/or predictive modeling.
  3. Combines seemingly unrelated data concepts to identify trends and to solve complex problems
  4. Designs experiments and tests hypotheses to support utilization and financial performance improvement initiatives.
  5. Integrates and prepares large, varied datasets, architecting specialized databases and computing environments from disparate data sources, and specifically with Epic.

Required Experience/Skills:

  1. Past experience includes evidence of leadership roles.
  2. Experience using statistical computer languages (R, Python, SQL, etc.) to manipulate data and draw insights from large data sets.
  3. Extensive knowledge of statistical and data mining techniques.
  4. Experience using statistical software such as SAS, IBM SPSS.6.Highly experienced in Data Visualization/presentation skills and experience with Tableau.
Apply Now!
 06/21/2022
Business Development Director Remote

Type: FTE
Exemption Status: Exempt
Location: Remote, 25% travel

Privia Health is a rapidly growing population health management company that is expanding across the US and into all avenues of the provider community. Currently, we partner with top physician practices to layer on prevention, wellness, and care management programs to keep patients healthy between visits. Traditional wellness and disease management programs designed to support out-of-office health, often leave out one of the most important stakeholders in managing an employee/member’s health – the physician. We believe doctors play a critical role in influencing wellness, so we’ve shifted the paradigm to drive wellness and care management interventions directly from the doctor's office. We are looking for an experienced, consultative business development leader excited by and capable of finding, developing, and executing relationships with provider organizations (ACOs, medical groups, IPAs, health systems) committed to value-based care. The primary focus of this role will be on growing the Privia Care Partners business unit that offers affiliated provider organizations the capabilities, capital, and expertise to be successful in value-based care models. This individual should have a diverse skill-set that can be deployed across all phases of the deal development process (market sizing/targeting, modeling, pitching, diligence, deal documentation) and should be energized by the complex process of creating a win-win relationship between Privia and a diverse set of provider organizations.

Duties

  • Develop, manage and deploy a go-to-market strategy and plan for Privia Care Partners, a value based care business model
  • Identify potential partners using quantitative and qualitative analysis
  • Develop multi-modal outreach campaigns targeting potential partners-Conduct initial meetings and presentations with target executives
  • Drive deal flow internally and externally across stakeholders
  • Create partnership pro-formas and financial models to communicate overall deal value
  • Draft partnership documents in partnership with legal and support complicated negotiations-Support other business development and deal activity as needed across the organization
  • Continually innovate and develop new, differentiated partnership models for Privia
  • Work with marketing to drive lead generation
  • Attend industry forums and event as necessary to generate interest

Minimum Qualifications

  • BA degree or higher required, focus on business administration or management a plus-8+ years work experience within healthcare with experience in strategy, growth, business development, or management consulting -Deep knowledge and understanding of value-based care payment models including MSSP ACOs and Medicare Advantage
  • Ability to present to healthcare executives in a compelling fashion-Ability to hit the ground running and immediately drive top-of-funnel activity-Strong experience in financial modeling, multi-workstream management, and Powerpoint
  • Experience finding, developing and closing large scale transactions such as mergers, acquisitions, and joint-ventures. Collaborative approach and passionate about innovation in healthcare
Physical Requirements
  • Ability to constantly remain in a stationary position-Ability to constantly operate a computer and other office productivity machinery, such as computer and printer
  • Ability to read and use close vision, including the ability to do so on a computer screen
  • Ability to use distance vision-Ability to frequently communicate and exchange information
  • Ability to frequently adjust focus-Ability to move about the office or to other locations as needed
  • Ability to occasionally position self to maintain equipment or materials including under desks
  • Ability to occasionally lift, push, or pull up to 15 pounds, usually in the form of boxes or other small packages
Apply Now!
06/16/2022
Sr. Project Manager - Clinically Integrated Network Wilmington, DE

Assists the broad Population Health team to achieve organizational goals by leading and managing key projects and initiatives that impact the Annual Operating Plan. Works collaboratively with all administrative and clinical leaders across all departments at ChristianaCare. Will play a lead role in the resource allocation and operational improvement of all Population Health function. 

PRIMARY DUTIES AND RESPONSIBILITIES 

  • Evaluate performance and process improvement methods (e.g., Lean, Six Sigma, Plan-Do-Check-Act Cycle) and apply those best suited to achieving successful outcomes
  • Use a range of quality improvement tools and techniques (e.g., Fishbone diagrams, 5 Whys, Value Stream Mapping, Failure Mode Effects Analysis, and Root Cause Analysis) and evaluate the output to successfully redesign processes toward improved performance
  • Access and use information resources to demonstrate current practice, identify opportunities for improvement, and strive toward improved outcomes
  • Communicate performance improvement priorities and results using narrative and visual tools (e.g., graphs, dashboards, and scorecards), providing a comprehensive context appropriate to the audience.
  • Assist in defining customer needs, expected benefits, and alignment of projects to the organizational mission, vision, values, strategic goals, and business priorities.
  • Design project plans to include opportunity statement, goals, scope, timeline, and critical milestones utilizing project management methodologies, performance measurements, and tools.
  • Manage the work defined (per a project plan, charter, and/or scope document) to ensure the project meets project goals and timelines.
  • Track, monitor, and communicate project progress to all stakeholders and provide notification to the project sponsor when deviations from the plan occur.
  • Promote a culture of trust, open communication, creative thinking, appropriate risk taking, continuous improvement and learning that leads to sustained results and optimal performance.
  • Facilitate an environment oriented to collaboration and problem solving.
  • Convey enthusiasm and strive to motivate, inspire and influence team members and other key stakeholders.
  • Communicate the vision, expectations, and results of performance improvement projects clearly, consistently, and appropriately to stakeholders.
  • Use meaningful measurement tools to prove the need for improvement, make changes, and measure return on investment
  • Identify, mitigate and collaborate with key stakeholders to remove barriers that impede sustainable change.
  • Implement accountability structures and controls required to deploy, monitor, and ensure compliance with the work changes required to achieve and sustain improved performance.
  • Provide the education, training, and tools necessary for effective implementation of process and workflow changes.
  • Remain current with applicable regulatory requirements
  • Manage, coach, and/or mentor less experienced quality professionals in higher level use of performance improvement tools
  • Train and mentor non—project managers in basic project management skills to raise the overall project management acumen in the organization
  • Identify, design and/or recommend resources and analytical methods to support the performance improvement activities to meet organizational goals/needs (i.e., dashboards incorporating clinical and business metrics tailored to strategic or operational goals)
  • Actively participate in systemwide management activities, attend meetings and in-service/educational programs and other activities as requested
  • Assume personal responsibility for ongoing professional growth; exhibit a high level of professionalism; serves as a role model for staff and others in the organization
  • Prepare and submit projects for publication and external presentation
Apply Now! 
06/08/2022
Practice Optimization Support Specialist Wilmington, DE
ChristianaCare is searching for a Practice Optimization Support Specialist to lead efforts to align population health concepts with primary care strategic goals. In this role, you have the opportunity to be a thought leader that will lead cross-functional teams to achieve the triple aim of healthcare through innovation and transformation. Our values of love and excellence are at the forefront of our work. It will serve as a guide as you collaborate with key stakeholders that include clinics on the development of cohesive team-based care; enhance care pathways by enabling and optimizing technology, and leveraging patient-centeredness to reduce total cost of care through engagement and optimization of quality, safety and patient experience. The successful candidate will have proven experience in change management and data analysis, with proficiency in electronic health records; preferably in Cerner. When you become a Caregiver at ChristianaCare, you are joining a healthcare organization that was named Forbes 5th Best Health System to Work for in the U.S. for 2021! Guided by excellence and love, our Caregivers enjoy many employee benefits such as work-life balance competitive pay and benefits generous paid time off diverse and inclusive culture
Qualifications
Bachelor's degree or other clinical degree, Operations, Business Administration, Healthcare Management, Statistics, or related field required. Master's degree preferred. Minimum of five years progressive and successful experience working in a direct patient care and/or improvement project / management environment required. Population health management/leadership experience with proven ability to develop effective programs preferred. Staff supervisory experience preferred.
Working conditions
Travel throughout the Christiana system is required. Work is typically performed in a clinical or office environment
Apply Now!
06/08/2022
Director Population Health Data Analytics Wilmington, DE

PRIMARY FUNCTION
The role will provide administrative and operational leadership for population health analytics to help to position data as a strategic asset that creates value in population health, including CareVio operations, Community Health, value-based programs, and ACO-CIN-type arrangements. There are several key areas of focus for the role: vendor sourcing and management, payer data relations, operational and administrative needs of the analytics team, workload balancing and portfolio management. The role will collaborate with many key stakeholders in data/analytics and population health business areas and take guidance and direction from the Vice President, Population Health Operations. The role requires both management experience and strong data and analytics acumen.  

PRINCIPAL DUTIES AND RESPONSIBILITIES 

  • Lead analytic strategies to identify opportunities to partner with clinicians to intervene in care pathways designed to optimize total cost of care relative to outcomes.
  • Leverage advanced analytical techniques to build practical, data-driven solutions for improving clinical, quality, and other key KPIs.
  • Serve as a champion for data optimization and utility pulling from a variety of data sources, ensuring enhanced usability of information systems while working with leadership to identify opportunities for clinical process improvements
  • Work closely with Clinical Analytics and Clinical Programs to identify rules-based program optimization opportunities and successfully implement.
  • Employ innovative new approaches to uncover rich insights into patient data and use these insights to develop strategic approaches.
  • Utilize market data, consumer research, and patient analytics to innovate digital solutions throughout the patient and member journey that significantly enhance overall satisfaction and loyalty
  • Developing and managing a structured, continuous, and consistent financial reporting process for value-based payer arrangements
  • Working closely with 3rd party payers (commercial insurance providers, Medicare, Medicaid) to obtain necessary data for financial modeling/analysis
  • Organize and coordinate analytic and data management strategies that focus on supporting system and customer goals to optimize results and to reduce duplication of effort and technology.
  • Encourage and foster a collaborative and supportive working environment for the population health analytics team, and targeted mentorship for population health analytics leadership core
  • Responsible for handling HR issues of the Population Health Analytics department including conflicts/issues/performance management, recruitment / staffing / retention strategies, and coordination of visa sponsorship for staff, where needed
  • Provide support, back-up and coaching for manager of population health analytics in overseeing the team technical staff
  • Leads in contract negotiations with external vendors for data/analytics services and products; monitor delivery of contractual obligations; Manages vendor relationships within areas of responsibility
  • Develops and maintains budget for population health analytics
  • Approve expenses and oversees purchases for the department
  • Accountable for team’s adherence to data stewardship standards in accordance with legal, privacy, and contractual obligations
  • Maintain working knowledge and awareness of emerging data/analytics solutions and benchmarking platforms in the pop health market; Evaluate vended solutions/services/platforms where needs arise
  • Ensures the population health analytics team is applying the most effective, appropriate analytic methods and scalable solutions.
  • Coordinate with center for strategic information management on pop health data management operations, master data needs, and Privacy/security/data stewardship issues
  • Oversee workload measurement and monitoring for both employed and contracted resources; report out personnel capacity assessment and business area support on a quarterly basis
  • Reviews contractual agreements for data/analytics services within areas of responsibility
  • Identifies and pursues opportunities for continuing professional development for the population health analytics team
  • Establishes and maintains processes that promote team effectiveness— working together with manager of pop health analytics and program coordinator on the execution-- including project management approach, intake request and review process, deliverable review process, and working groups with business areas
  • Performs assigned work safely, adhering to established departmental safety rules and practices; reports to supervisor, in a timely manner, any unsafe activities, conditions, hazards, or safety violations that may cause injury to oneself, other employees, patients and visitors.
  • Performs other related duties as required.
Apply Now!
06/08/2022
Data Consultant - Value Based Performance National Remote

This job identifies, interprets, and translates the needs of operational areas and matches them to the capabilities of the data and analytics teams. Serves as a business subject matter expert and a liaison between operational areas and the data and analytics teams to ensure forward progress on system initiatives.

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable qualified individuals with disabilities to perform the essential duties.

This job description is a summary of the primary duties and responsibilities of the job and position. It is not intended to be a comprehensive or all-inclusive listing of duties and responsibilities. Contents are subject to change at the company's discretion.

Education
Required – Bachelor’s degree.
Preferred – Master’s degree.

Work Experience
Required – 5 years of experience in healthcare information technology, business intelligence, data management, or related field.
Preferred – 7 years of in experience in healthcare information technology, business intelligence, data management, or related field.

Job Duties

  • Interprets and documents business needs to support the development of analytics solutions.
  • Analyzes data, interprets results, and outlines opportunities using analytical techniques and contributes to the ongoing strategy.
  • Collaborates and communicates with assigned customers/end users.
  • Evaluates and understands assigned business processes, challenges, and goals.
  • Supports all facets of assigned project(s) through the project life cycle.
  • Maintains and enhances professional competency.
  • Performs other related duties as required.
Apply Now!
05/25/2022
 Controller - on-site Jupiter, FL (on-site)

The Controller is an integral part of building and supporting ilumed’s financial infrastructure by managing the daily operations of the finance function as well as managing, maintaining and reporting on financial information necessary for company leadership to make informed decisions and track financial metrics. In addition, the Controller will develop innovative reporting tools to drive increased communication on results, opportunities for improvement, and to highlight key successes. 

ESSENTIAL FUNCTIONS 

  • Perform all accounting and financial operations including the general ledger, revenue, inventory management, fixed asset recording, AP/AR, and cash flow management.
  • Prepare, analyze and interpret balance sheets, income statements, cash flow, and liabilities.
  • Oversee financial and accounting staff, providing guidance and direction regarding daily activities and projects.
  • Interface with all functional areas and service providers to observe and analyze financial & operational data on a regular basis to identify cost drivers, operational efficiencies and overall performance.
  • Establish, document and monitor closing processes, billing, invoicing, expenses and reimbursements to ensure compliance with GAAP, SOX and all other regulatory requirements.
  • Reconcile and account for booking of expenses/payables in agreements and other legal contracts to ensure payments are made consistent with the agreements.
  • Review monthly journal entries and financial variance reports to accurately close the monthly fiscal period.
  • Coordinate the development, tracking, review and reporting of annual operating budgets and performance projections. Review bonus calculations based on operational & financial metrics.
  • Partner with senior leadership to develop and establish standard financial data sets, report schedules and progress updates compared to projections •Coordinate data collection, documentation and report forecasted business activity and financial position for updates compared to projections.
  • Conduct and/or coordinate internal audits and financial risk assessments and facilitate intervention strategies.
  • Prepare accurate and timely information for management and investors.
  • Prepare all year-end tax documents for the company and contracted providers.
  • Other duties as assigned. 

KNOWLEDGE, SKILLS, AND COMPETENCIES 

  • Ability to multi-task, manage multiple projects and conflicting priorities.
  • Knowledge of financial reporting laws and regulations.
  • Strong verbal and written communication skills.
  • Attention to detail.
  • Problem solving and critical thinking skills.
  • Proficiency in MS Office Suite. 

EDUCATION AND EXPERIENCE 

  • Bachelor's degree in Accounting or Finance required.
  • A minimum of 5 years of full cycle accounting experience preferably within the financial industry.
  • Minimum of 2 years of direct managerial or supervisory experience.
  • CPA, CGMA or similar certification preferred. 

PHYSICAL REQUIREMENTS 

  • Prolonged periods of sitting at a desk and working on a computer. 

ADDITIONAL INFORMATION 

  • Must abide by all HIPAA, Confidentiality & Privacy Laws
  • Must be on-site during regular business hours unless otherwise assigned •Must be able to travel up to 25%
  • Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions of the job.

Please submit resume and salary requirements to Annette DiPiero at [email protected].

 

05/06/2022
Healthcare Contract Database Manager Jupiter, FL (on-site)

The Healthcare Contracts Database Manager manages and maintains the Master Provider database and subsidiary databases, the Master Contract Negotiation Contact database, and the CMS 4i database. The Healthcare Contracts Database Manager coordinates data maintenance in BrainStream and provides all necessary reports from all databases as requested by leadership. In addition, the Healthcare Contracts Database Manager provides support to the Executive Administrator regarding daily office operations and projects. 

ESSENTIAL FUNCTIONS 

  • Establishes and maintains a master provider database with all required data elements; collects and compiles data from multiple sources; ensures data is current, accurate & complete; updates, adds, deletes and/or modifies data.
  • Maintains a master contract negotiation contact database as received from various networks.
  • Maintains CMS 4i database, contacts providers for updated or missing information, coordinates uploads, downloads, and reports.
  • Reviews communication from CMS including e-mail notifications, training, conference calls and takes action as required.
  • Educates departments on all CMS correspondence, evaluates information received from CMS and either takes the required action and/or coordinates completion of required action by the appropriate department
  • Conducts annual 4i data submissions as scheduled by CMS to include all necessary updates to achieve accurate provider network submissions, and submission of provider-level TCC percentages. •Reviews New Provider roster received from the Network Team based on newly signed contracts, adds new provider information to the master provider database, master CMS notices file and the website provider directory.
  • Sends provider F.A.Q.s to newly contracted providers.
  • Sends required CMS notifications to newly contracted providers
  • Reviews monthly rosters received from contracted groups/systems, adds/deletes/modifies existing provider information in the master provider database, master CMS notices file and the website provider directory.
  • Conducts research on all “deleted” care providers from monthly provider rosters, documents the care provider’s new group/network and determines if the group/network is or is not already contracted with ilumed.
  • Compiles a monthly report reflecting the care providers no longer with the contracted group/network.
  • Runs monthly OIG reports, identifies any contracted care providers on the list, notifies groups/networks, and updates all databases / directories as required.
  • Updates all databases to reflect all care-provider changes.
  • Performs general administrative tasks as requested to include maintaining records/files, compiling reports, scanning documents, and scheduling meetings.
  • Provides administrative support on projects and initiatives.
  • Acts as back up for Executive Administrator as needed.
  • Performs other duties as assigned. 

KNOWLEDGE, SKILLS AND COMPETENCIES 

  • Advanced Level Excel and other Microsoft Office Suite software
  • Data aggregation software
  • Verbal and written communication
  • Analytical and problem-solving
  • Organizational and time management
  • Accuracy and attention to detail
  • Project management
  • Multi-tasking 

EDUCATION AND EXPERIENCE 

  • Associate’s degree in business or information technology-related field or equivalent experience.
  • Three – five years of experience managing electronic data, preferable in healthcare.
  • PHYSICAL DEMANDS
  • Sitting, standing, bending, reaching and the ability to mobilize throughout the office.
  • Pro-longed work at computer monitors.
  • Lift and/or move up to 10 lbs. 

ADDITIONAL INFORMATION 

  • Must abide by all HIPAA, Confidentiality & Privacy Laws
  • Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. 

Please submit resume and salary requirements to Annette DiPiero at [email protected]. 

05/06/2022
Director of Network Development Jupiter, FL (on-site)

The Director of Network Development will provide an essential management role to support retention and expansion of ilumed’s provider network. Serve as a key team member in establishing quality-based, cost-efficient provider networks and form viable provider partner relationships for the benefit of ilumed customers. Establish provider networks and apply performance-based reimbursement structures as appropriate to enhance quality and efficient care models. Work cooperatively with colleagues to fulfill ilumed’s vision of excellence in health management. 

ESSENTIAL FUNCTIONS 

  • Develop strategic partnerships to support company vision and goals
  • Implement policies, procedures, and quality standards for network management
  • Ensure provider network footprint supports clinical leadership requirements for a top performing provider network that yields cost efficient quality outcomes
  • Establish meaningful provider network growth that aligns with needs of beneficiaries
  • Evaluate provider network performance for improvement opportunities
  • Implement budgeting and forecasting procedures to comply with targets set for network management activities
  • Work with senior leadership team to analyze claim trend data and to incorporate results into strategy decisions for contract negotiations
  • Assist in the development of quarterly reports for the senior management team to report on provider network footprint, membership growth by state/county and forecast of market expansions
  • Assist in governmental relationships and compliance with CMS guidelines
  • Assist VP of Network Development in managing CMMI annual deadlines for provider network submissions
  • Other duties as requested 

KNOWLEDGE, SKILLS AND COMPETENCIES 

  • Good organizational skills and ability to handle multiple priorities and deadlines
  • Ability to work independently and manage multiple projects simultaneously under deadlines
  • Proficiency in Microsoft Office products (Word, Excel and Outlook)
  • Make timely proficient decisions and complete assigned tasks independently
  • Strong negotiation skills, strong closer
  • Attention to detail, highly organized in creating workflows and executing deliverables
  • Ability to analyze financial reports and identify trends/variances “Big Picture” thinking
  • Highly effective oral/written communication skills
  • Adapts quickly to changes needed to expand vision and facilitate vision execution
  • Strong analytical problem-solving aptitude with creative solutions, ability to organize work with large amounts of information efficiently, manage multiple projects and deadlines simultaneously with strong attention to detail
  • Ability to communicate effectively and professionally, both in writing and verbally, with management
  • Open to development of skills and knowledge
  • Willingness to be flexible and adaptable to change
  • Demonstrates flexibility in organizational needs to perform other duties as assigned 

EDUCATION & EXPERIENCE 

  • Bachelor's degree or equivalent experience in Business Administration, Healthcare Administration, or related field. MBA or MHA degree preferred•4+ years negotiating provider contracts including physician, ancillary and hospital with multiple payment methodologies•2+ years’ experience with global risk/full delegation contracts•2+years of experience in population health/global risk network development and provider relations/contract management in a health care and/or managed care environment.
  • Provider relations experience 

PHYSICAL REQUIREMENTS 

  • Ability to travel to the corporate office at least one day every other week and occasional travel to customer and/or other locations.
  • Sitting, standing, bending, reaching and the ability to mobilize throughout the office.
  • Pro-longed work at computer monitors.
  • Lift and/or move up to 10 lbs. 

ADDITIONAL INFORMATION 

  • Must abide by all HIPAA, Confidentiality & Privacy Laws
  • Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions of the job. 

Please submit resume and salary requirements to Annette DiPiero at [email protected] 

05/06/2022
Account Manager Malvern, PA

The Account Manager serves as the primary business contact for the client and is responsible for client satisfaction for our MIPS suite of products. The AM is expected to consistently provide excellent customer service to accounts, as well as represent client needs and goals within the organization to ensure quality. In addition, the AM will build relationships with existing clients to encourage new and repeat business opportunities.

Please email resume to Mike Lewis @ [email protected]

05/02/2022
Executive Account Manager Malvern, PA

This position’s primary responsibilities involve the onboarding and relationship management of new ACO opportunities within our product APP Impact and MIPSpro. The Executive Account Manager serves as the primary business contact for the client and is responsible for coordinating the technical implementation of our product, ensuring that clients successfully meet goals defined during onboarding, and growing the client relationship.

Please send resume to Mike Lewis @ [email protected]

05/02/2022
Healthcare Actuarial Specialist Miami, FL

Health Choice Network (HCN) has been an employer of choice in South Florida for the past 26 years. HCN is poised to attract top talent by offering a robust benefit package, providing health insurance coverage for individual and family and more. HCN offers competitive compensation, retirement plan, professional development to name a few. Our corporate office design is inspired by the Herman Miller Living Office concept work environment, providing a high-performing workplace that deliver an enhanced experience of work for our employees. With 52 safety-net organizations in nineteen states serving approximately 2.2 million patients, HCN is recognized as a leader in the integration of health information technology among health centers and safety net providers. HCN provides key business services, strategic initiatives and the latest in health information technology.

Position Summary
This position is responsible for supporting the strategic financial objectives of HCN Value Based Services team and collaborate with payers to ensure the appropriate information is available to drive improved performance, decision-making and support business needs. This position assists the VBS Director in identifying, quantifying, and managing financial and related operational risks to any areas of assumed financial risk by the organization, including ACO, and managed care contracts.

Apply Now!
04/28/2022
Manager, Valued Based Operations Miami, FL We’re a family of health centers, supported by a family of Associates. For over 25 years, Health Choice Network (HCN) has been an employer of choice in South Florida, supporting health centers, patients, and the communities they serve. We are one of the first successful health center-controlled networks and our success is due largely to our Associates and their commitment to advancing our mission to improve the health status of our communities. Do you want to join an organization that believes in empowering their most precious resource, their Associates? Are you innovative and results driven? HCN is looking for talented, qualified individuals to join our rapidly expanding, first-class team. This position is responsible for managing and driving success with all network related projects and issues. Manage all technical aspects of network by planning, implementing and reviewing network infrastructure and services.

Apply Now!
04/28/2022
Director, Valued Based Operations Miami, FL We’re a family of health centers, supported by a family of Associates. For over 25 years, Health Choice Network (HCN) has been an employer of choice in South Florida, supporting health centers, patients, and the communities they serve. We are one of the first successful health center-controlled networks and our success is due largely to our Associates and their commitment to advancing our mission to improve the health status of our communities. Do you want to join an organization that believes in empowering their most precious resource, their Associates? Are you innovative and results driven? HCN is looking for talented, qualified individuals to join our rapidly expanding, first-class team. The Director of Value Based Operations is responsible for developing and maintaining meaningful payer and provider relations across HCN’s MSO and ACO networks. This role is accountable for developing strategic opportunities that translate into enhanced value-based care contracting opportunities.

Apply Now!
04/28/2022
Senior Value Based Care Financial Consultant - Healthcare Analytics Startup Remote

Want to make a tangible difference in the future of accountable care?

Love applying the latest technologies and statistical models to solve tough problems?
Looking for a fulfilling career that gives you autonomy, mastery and purpose?
We are a small team of data scientists, actuaries, programmers and healthcare economics experts who love what we do and wouldn’t trade it for the world. Join us!

THE COMPANY
Validate Health provides financial simulation, economic forecasts and actuarial risk management services for healthcare providers to thrive within the always evolving and complex value based care (VBC) programs. Our mission is to enable provider accountable care organizations (ACOs) to focus on taking care of patients, while we take care of their highest impact strategic VBC decisions.

JOB DESCRIPTION
As a Value Based Care Financial Consultant, you’ll leverage our broad data assets, analytics technology, statistical models and actuarial knowledge to delight our clients and enhance our products. First, you will be helping our provider clients evaluate and implement existing and upcoming VBC programs. Second, you will be able to geek out in translating evolving client needs and changes in VBC regulations into product specifications and implementation plans. And you can do all this with NO TRAVEL — from the comfort of your home office. Key responsibilities and approximate time allocations are:

Client deliverable support (40%)
Serve in a client-facing role, interacting with executives of health systems, physician groups and other provider organizations. Become a trusted advisor with clients’ leadership over time.
Help prepare deliverables tailored to each client, including recommendation write-ups, data visualizations and presentation decks.
Synthesize data from spreadsheets and reports to formulate client recommendations. Calculate and present the expected return on investment, downside risk exposure, and payback time frame for each decision scenario.

Product management (30%)
Provide your understanding of client feedback and expected changes to regulations to support development of internal intellectual property and contribute to advancing the product roadmap.
Manage incoming client requests, identifying which should be developed into product features.

Regulatory & Policy Analysis (20%)
Monitor upcoming and proposed regulatory changes for accountable care organizations (ACOs), with focus on the Medicare Shared Savings Program (MSSP), Global Professional Direct Contracting (GPDC), Medicare Advantage (MA), and future evolving VBC programs.
Identify how they may impact the industry, Validate Health’s clients, and the product roadmap.

Education and Business Development (10%)
Build industry thought leadership recognition by supporting translation of research and client experience into publications, client case studies, and educational webinars.
Support incoming leads, prospective client follow-ups, proofs of concept, and proposal development.

REQUIREMENTS
Must have foundational literacy in value based care (VBC), such as evaluating programs, health plan implementation, provider network design, healthcare finance, or revenue cycle.
Degree from a competitive university program in MPH, MHA, MPH, Healthcare Economics, Healthcare MBA, or similar. Other degrees could be considered if the candidate has substantial experience in the field.
Opportunities available at two levels – Senior level: 5+ years work experience in VBC. Junior level: Recent masters degree graduates with 1+ years equivalent work experience in VBC.
Experience in any combination of the following is beneficial

  • Regulatory and policy analysis for ACO programs (MSSP, NGACO, GPDC), Medicare Advantage (MA), or CMMI’s experimental models
  • Statistical analysis of healthcare claims and provider network data
  • Client-facing healthcare strategic consulting
  • Product management of technology-enabled services

Ability to manipulate data using at least one data processing, statistical, or visualization tool, such as SQL, SAS, R, Python, or Tableau.
Excellent written and oral presentation skills with a track record of producing high quality work product. Skills in active listening and note taking, with the ability to synthesize quickly incoming information into an action plan.

We are looking for team players who can work well in an agile, start-up environment, adapt to industry changes, and are excited to develop and grow professionally with the company.

Must be willing to try a fun written take home "challenge" early in the interview process to help us understand your level of comfort with analysis relevant to this position. (It's a set of real-world problems that our team has solved in the past and also serves to give you a glimpse into what we do.)

BENEFITS
Fully remote team with an environment and company culture that's optimized to provide a fulfilling work experience and career growth opportunities to every team member, regardless the location
Fun, energetic, collaborative and rewarding learning environment with daily whiteboard sessions and weekly "deep thought" days
Opportunity for continuous personal growth and development through research projects and agile experimentation mindset towards product development
Profit sharing and stock options
Health coverage and 401K

TO APPLY
Send in your resume to [email protected].
Write a note explaining your long-term career goals and what makes you particularly interested in Validate Health and this position specifically.
Include links to LinkedIn and any other resources that you feel speak to who you are and your capabilities, such as publications, blog or portfolio.
Specify the date you’re available to start work, visa/citizenship status, and any sponsorship requirements. (Must be in the U.S. and available full-time within 2 months.)
Indicate that you’re willing to go through our hiring process: Screening video interview ⇒ Written "Challenge" skills questions ⇒ 2-3 culture and skills interviews ⇒ Meet the team and micro project. (Elapsed time from first response to job offer could be within 7 days.)
Add “Sr VBC Financial Consultant via LinkedIn” to the subject line.

04/20/2022
Senior Value Based Data Analyst Remote

Reporting to the ACO Executive, the Senior Healthcare Data Analyst is responsible for supporting the analytic needs of Dignity Health Care Network, a clinically integrated network (CIN) participating in the Medicare Shared Savings Program (MSSP).This position is responsible for the development and management of analytic solutions designed to drive clinical, quality, and financial operational efficiencies within the Medicare Shared Savings Program. This position requires an in-depth understanding of healthcare data (e.g. member, claims, clinical and provider data) and operations coupled with an extensive knowledge of large data set development, quantitative data analysis methodology and analytical tools for reporting. The Senior Healthcare Analyst routinely supports business decisions and operational processes and frequently interacts with other key management staff. Search for Requisition ID 2022-226968 at commonspirit.careers

Apply Now!
04/19/2022
Chief Legal Counsel Colchester, VT The incumbent will serve as the Internal Legal Counsel for OneCare Vermont, a statewide Accountable Care Organization (ACO) and as a member of the Office of General Counsel of the University of Vermont Health Network (UVMHN). Juris Doctorate from an accredited law school with current, unrestricted licensure in the State of Vermont. A minimum of 10 years of relevant experience, preferable including at least 3 years serving as in house counsel. Extensive experience in healthcare law and specific expertise in working with large systems including hospital networks and/or Accountable Care Organizations is strongly required. Must work collaboratively across all levels of the company. Must have superior communication skills including written, verbal and interpersonal skills and be able to listen effectively, solve problems, anticipate issues and make effective decisions. OneCare is a fast-paced, innovative organization in the evolving field of health care reform. Employees at OneCare have the opportunity to challenge themselves and grow while working in a collaborative environment striving for excellence together. We are a mission-driven organization that values equity, communication, and integrity. Because health care touches all Vermonters, we aim for continuous improvement in all that we do.

Apply Now!
04/12/2022
Chief Medical Officer, Kootenai Care Network Coeur d'Alene, ID

Kootenai Health (KH) seeks a contemporary and experienced population health physician executive to serve as the Chief Medical Officer, Kootenai Care Network (KCN).Kootenai Health (KH) launched its clinically integrated network in 2016 with a focus on new payment and contracting methodologies emerging in the market. Today KCN has over 600 providers and 8 hospitals. The Network will expand to 65,000 covered lives as of January 2023. Kootenai is a rapidly growing regional health system consistently recognized as a Gallup Great Workplace Award recipient, Magnet Hospital designation since 2006 and is a member of the Mayo Clinic Care Network. Today, KH has 3,500 employees, over $800 million net revenue and an "A" rating by S&P.Coeur d’Alene is situated 30 miles east of Spokane on beautiful Lake Coeur d’Alene recognized as one of the Northwest’s most desirable communities and an increasingly popular destination.To find out more, please contact Lisa Lewis, preferably via email at [email protected] or at 630-575-6122.

04/11/2022
Director, Clinical Document Improvement Texas-based (details can be discussed)

The Director of Outpatient CDI will be responsible for directing multidisciplinary teams, leads technical and clinical staff in coordination of all the phases of the program life cycle including: analysis, reporting, planning, implementation (to include new software), testing, education and training, productive use, fiscal management, ongoing support and quality management. The role should work closely with Revenue Cycle, HIM, Compliance and Quality to determine opportunities for CDI.

Apply Now!
 03/30/2022
Director of Practice Transformation Scottsdale AZ

In partnership with the Chief Medical Officer, the Director of Practice Transformation is responsible for supporting design, implementation, and execution of clinical and operational performance and processes, with focus on quality of outcomes and superior service. This position serves as an advisor to the organization's senior operating team on matters related to strategic planning, clinical and operational relations, financial goals, and quality and safety initiatives as developed by senior leadership.

  • Leads and guides providers to ensure excellence in clinical outcomes by providing leadership and expertise in the development, design, implement and evaluation of clinical and operational process performance. Incorporates best practices to enhance operations, programs, and/or services. Evaluates, designs, and implements strategic programs, develops effective tools to measure performance, analyzes related data, prepares reports, and makes recommendations to senior leadership based on findings.
  • Builds and supports effective relationships with internal and external stakeholders and organizations. Develops partnerships, coordinates activities, reviews work, exchanges information, and/or resolves problems related to clinical and related operational process performance.- Leads and directs the Population Health department, supporting the organization's innovation, development and operations to drive performance in value-based agreements across providers, practices, and payers.-Develop and implement tools and network capabilities around population health, Risk Adjustment Factor score improvement, provider engagement and enterprise performance, utilizing technology tools to support practice transformation.-Develop and lead RN provider educator team to drive implementation of quality and risk tools and sustain ACO priorities at the clinician level.
  • Participates as a subject matter expert and may lead or facilitate work groups, teams and other meetings. Requirements: Physician Assistant (MS/MMS/MSPAS/MPAS) or Nurse Practitioner (MN or MSN from NLN or CCNE); 3 years clinical experience Preferred: 5 years of clinical experience and supervisory or leadership experience

Please send cover letter and CV to [email protected] or call 480-696-4020 for details on applying for this position.

02/17/2022
Medical Director of Value Analytics Scottsdale AZ The Medical Director of Value Analytics will lead the organization's population health informatics functions through the transition towards population health improvement, providing leadership within the organization and network. The Medical Director will use population health informatics strategy to drive business, patient, and community outcomes, expertise in value-based analytics merging claims and clinical data to manage financial and clinical risk, and participates in refining the technology strategy, investments, and platforms needed to support population health informatics centric goals. The Medical Director works with the informatics department, assumes the task of liaising with the Chief Technology Officer and IT teams, and serves as an advisor to the organization’s senior operating team on matters related to the analytics vision, tools, and capabilities for departments to leverage analytics as an asset and strategic tool. Job requirements: MD/DO with clinical leadership and healthcare informatics experience, prefer board certified in CI or MBA/MPH/MSHI/MMM.

Please send cover letter and CV to [email protected] or call 480-696-4020 for details on applying for this position.
02/17/2022
ACO Program Coordinator Newton, MA (Hybrid) Has primary responsibility for the oversight and implementation of a small to mid-size non-clinical program typically within a single functional or specialty area. Coordinates all activities necessary to fulfill program objectives. Develops and implements program guidelines, processes, and systems. 
  • Assesses and regularly reviews the overall focus of the program and identifies areas for improvement. This may include conducting needs assessments or operational analyses to ensure program continues to meet an identified business need.  
  • Provides recommendations and analyses to management as needed for the development of program related initiatives, including conducting needs assessment, operational analyses, and systems and/or overseeing process development. Collects and provides analyses on data needed for the management decision-making purposes. 
  • Serves as a resource to both internal and external customers on all program operation issues. Resolves problems and responds to program inquiries. Independently evaluates potential courses of action to reach resolution and either implements or presents recommendations to manager. May also identify potential obstacles and makes recommendations on alternative courses of action. Is able to resolve or make recommendations matters of significance to the program’s success and development beyond daily administrative and business matters. 
  • Maintains on-going relationships with outside agencies, consultants, contractors, and other strategic partners as needed. May work on joint collaborations. 
  • If applicable ensures company compliance with all regulatory or accreditation issues needed for the continued operation of the program. Develops and implements policy, procedures, and systems in order to maintain compliance. Submits all required paperwork and materials needed by external agencies. 
  • Creates and/or updates written material and documentation related to the program. May determine content of what needs to be included. 
  • Performs administrative duties needed for the on-going operation of the program.· May supervise support staff. May oversee work of staff involved in program implementation. 
  • May assist or be responsible for the preparation and maintenance of the program budget. May produce monthly variance reports. 
  • Performs all job functions in compliance with applicable federal, state, accrediting bodies, local and company policies and procedures.

Please send resume to [email protected]

01/16/2022
Director, Clinical Documentation Integrity Winston-Salem, NC

Due to our continued growth CHESS Health Solutions is seeking a Director of Clinical Documentation Integrity for our corporate headquarters in Winston-Salem, North Carolina. We are a physician-led health services company co-owned by Wake Forest Baptist Medical Center and Laboratory Corporation of America, empowering clinicians and health systems to make the transition to value-based medicine.

Responsibilities

  • Serves as the primary CHESS team member to educate Value Partners on the importance of accurate, compliant documentation and coding of medical conditions, including a comprehensive understanding of the CMS-HCC risk adjustment model.
  • Educates CHESS team members internally, ensuring that relevant employees are aware of changes and updates to ICD-10 Coding guidelines and CMS-HCC risk adjustment model. •Provides oversight and guidance to CDI Specialists who serve CHESS Value Partners with chart reviews and queries.
  • Participates in the development of other educational curricula.
  • Functions as part of the implementation and operations teams.

Winston-Salem NC features a moderate climate with all four seasons and housing costs ≈30% below the national average. Residents enjoy a vibrant restaurant scene, a wide variety of indoor and outdoor recreational opportunities, strong public/private schools, enthusiastic support for the arts, and close proximity to the Appalachian Mountains and Atlantic Coast beaches.

Requirements

  • Bachelor’s Degree in healthcare related field or business administration
  • Clinical Documentation and Coding certification (ACDIS, AAPC, or AHIMA)
  • Clinical experience preferred
  • 2+ years’ experience with HCC coding education

CHESS Health Solutions offers a very competitive compensation package including: base salary, incentive bonus, comprehensive benefits and relocation assistance (if required).

Please send your resume to [email protected]

12/15/2021
Data Analyst Central Florida

We are seeking an ACO data analyst to work with our CEO in the preparation of reports and summaries for presentation to ACO Physicians and staff. Experience working with CMS (Medicare) data is a plus. Candidate must be expert in MS Excel and Power Point. Compensation includes base plus bonus and ranges from $60,000 to $100,000 based on experience. Position is located in central Florida and is available immediately. There is a $5,000 signing bonus for the successful candidate.

Send resume to [email protected].

11/30/2021
CIO Central Florida

We are seeking a CIO (Chief Information Officer) to work with a management company providing data analytics for two very successful ACOs in central Florida. The CIO reports directly to the CEO. ACO experience is a plus in addition to working with CMS (Medicare), QASR and QEXPU files, utilizing data in charts, graphs, and reports. Candidate must have ability to prepare in-depth data analytics in clear and understandable summaries and present them to ACO Physicians and staff. Along with CEO, CIO also attends monthly meetings with both ACOs. Compensation includes base plus bonus and ranges from $90,000 to $200,000 depending on experience. The position is available on or before 2/1/2022. There will be a $10,000 signing bonus for the successful candidate.

Send resume to [email protected].

11/30/2021
Senior Financial Analyst Olympia, WA

Are you ready for something big? PSW is in search of new talent to help grow our team. No global movement stems from individuals; it takes an entire team to create something big. At PSW, we work hard, laugh often, dream big, and drive progress. We believe that PSW is more than a job…it's an adventure in healthcare innovation. If you like what you see, we want to hear from you! WHO IS PSW?A Population Health Company founded in 1995. PSW has led healthcare innovation with the guiding principle of supporting the physician-patient relationship to improve quality of care. PSW’s diverse lines of business include successful management of delegated risk contract, launching a Medicare Advantage plan, standing up a national leading ACO, and building the infrastructure to manage population health across all payer models. The Senior Financial Analyst applies analytical thought processes and reporting expertise to translate financial and clinical data into impactful financial analyses. The analyst will report to the Director of Finance and, under minimal supervision, manage specific assigned responsibilities as it relates to budgets, cost accounting, and financial decision support. The analyst will develop custom reports/dashboards and ensure the accuracy of financial models that support operational and strategic decision making for multiple lines of business. Additionally, the analyst will perform forecasting for value-based contracts.
To apply, please email your resume to [email protected] with the position you would like to apply for or visit our careers page at www.pswipa.com/careers.

11/21/2021
Director of Operations Temple Terrace, FL

Chapters Health System – leading the way in end-of-life-care from palliative care and hospice for adults and children suffering with life-limiting illnesses to in-home healthcare and community-based services – has an excellent opportunity for a Director of Operations for CareNu, a new division of Chapter Health System. CareNu is a new approach to population health management specializing in holistic care across the disease continuum – providing Chapters Health-quality care further upstream than ever before. As the Director of Operations, you will be responsible for supervision of the administration of operational services being conducted by CareNU across the entities’ lines of business with detail to coordination of care, network services, provider relations, and other sub-delegated functions. In addition to the ability to work in a fast-paced, flexible environment, ideal candidates will have:

  • Bachelor’s degree in business administration, health care administration, or public health or an equivalent combination of work experience and education; MBA or MHA preferred
  • Five (5) years of experience in a managed care organization or risk bearing entity
  • Three (3) years of operational management experience• Working knowledge of managed care principles, payment methodologies, and clinical pathways normally utilized in value-based settings• Value-based and alternative payment models proficiency

A great place to live and work. As a premier employer throughout West Central Florida, we offer a competitive salary and benefits package, and we are honored by our re-certification as a great workplace in the Aging Services category by the Great Place to Work® Institute for the fourth year in a row. chaptershealth.org/about-us/careers/Equal Opportunity Employer

Apply Now!
 10/04/2021
Value Based Care Program Manager Hollywood, FL

Do you have at least 3 years of clinical experience and a desire to drive change across the healthcare system for better outcomes, all without sacrificing your family time or mental health? Are you a passionate and energetic RN with knowledge about Value Based Care and Population Health? If yes, then our Value Based Care Program Manager opportunity may be the right fit for you!

Our Value Based Care Program Manager is meant to partner with operations, analytics, clinical leadership, care management, utilization management, network strategy and patient engagement teams. The VBC Manager will also coordinate care transformation solutions which will provide improved outcomes, good transition of care and avoid readmissions.

Memorial has been recognized for the twelfth time as one of the Best Places to Work in Healthcare (Modern Healthcare, 2009 – 2021). We offer abundant growth opportunities, an authentic employee engagement culture, and wide ranging benefits (from pension, healthcare and identity theft protection to education assistance and virtual doctor visits) – no wonder so many employees build and grow their entire careers here!
For a full job description and to apply.

Apply Now!

 

09/21/2021
PACE - Medical Director Lynchburg, VA

Centra Health’s PACE is a Program of All-Inclusive Care for the Elderly designed for frail older adults who want to live at home and have their primary care and supportive services provided in collaboration with a physician.

The PACE Medical Director is responsible for the delivery of participant care, clinical outcomes, and for the implementation, as well as oversight, of the quality improvement program for all PACE programs in our three locations: Lynchburg, Farmville, and Gretna. In a dyad relationship with the Executive Director, this person will provide leadership and a value-based vision to PACE. The Medical Director shares the administrative functions that directly impact PACE providers as well as collaborates with operations in areas of strategic planning, finance, and data driven performance improvement.

Required Qualifications

  • Primary location will be in Lynchburg, but will provide care at our Farmville, Gretna, and Danville locations.
  • 50% administrative and 50% clinical.
  • Completion of a medical degree and residency training from an AMA approved program or other schools with credentials approved by the Medical Staff and Board of Centra. Geriatric specialty preferred.
  • MD/DO with certification by an American Board of Medical Specialties (ABMS) board in physician's primary specialty.
  • Minimum of 2 - 3 years of supervisor/administrative experience in a clinical setting.
  • At least 1 year experience in a PACE or value-based care model. Physician

Benefits

  • Up to $250k in total compensation
  • Up to $20k in upfront bonuses
  • Up to $10k in relocation reimbursement
  • Up to 100k in student loan repayment
  • 403(b) and 457(b) tax deferred savings plan; vested employer contribution match
  • Paid Time Off
  • Health, dental, vision, and malpractice insurance
  • Flexible spending account options

Our Healthcare System
Centra Medical Group (CMG) is physician-led and comprised of 500+ physicians and advanced practice providers and serves 250,000 central and southern Virginians. Centra Healthcare System offers an integrated healthcare system, including 4 hospitals, 4 long-term care facilities, 60+ physician practices, including primary care, medical and surgical specialists.

Our Community
Located in the heart of Virginia, Lynchburg is a thriving city known for its history, outdoor beauty, and quality of life. It’s big enough to offer amenities such as convenient air and rail service, yet small enough to be free of gridlock and urban crime rates. Lynchburg is conveniently located along the Blue Ridge Mountains in Central Virginia, just three hours from Washington, D.C. and coastal beaches, and only minutes from lakefront communities, mountaintop trails, and ski slopes. The area also provides a broad range of housing options, acclaimed schools, a vibrant arts community, and temperate weather.

Email CV and cover letter to: [email protected]

 

09/16/2021
Senior Contracts Administrator
Denver, CO and fully remote

Ability to work fully remote! Open to part time or full time employee. 

Senior Contracts Administrator develop, drafts, prepares and administers contracts, bids, and proposals that meet specifications and complies with all policies, regulations, company standards, industry best practices, reimbursement structure standards, and other key process controls. Reviews contract terms to identify any potential risk or compliance issues. Examines supporting materials and agreement documents related to bids or contracts and provides guidance. Acts as a liaison between the organization and subcontractors to implement the contracts. Maintains contract records used to ensure compliance with reporting and regulatory requirements. Experience drafting contracts from the beginning, as well as reviewing contracts for compliance and protection, is essential in this role. Responsibilities also include working collaborative with all departments and multiple lines of business to ensure all contract types meet relevant laws and regulations before the company commits to the agreement, and then monitors adherence to the contract's terms. Ability to work autonomously to draft and execute varied healthcare contracts. Maintains corporate legal functions including business licensing, trademarks, and insurance applications. A strong understanding of a corporate legal department and its operations, including litigation, contracting, and other areas.

Salary Range:$70,964.00 To 88,705.00 Annually

Apply Now!
08/27/2021
Member Support Specialist Denver, CO and mostly remote

Primarily work from home!

The Member Support Specialist will have extensive knowledge of local, community-based supports, to include social supports as well as medical and behavioral supports, in order to successfully connect members with existing health services and effectively navigate the health system. The Member Support specialist will provide customer service for member inquiries, to include answering eligibility and enrollment questions, administering health needs assessments, identifying barriers and presenting solutions, and triaging patients to a higher level of care coordination, in order to assist members with maximizing their use of the health system. The Member Support Specialist will provide customer service for physical and behavioral health provider inquiries, to include answering questions and connecting providers with available resources across the health system

Salary Range:$16.3400 To 20.4300 Hourly

Apply Now!
08/27/2021
Contract & Legal Affairs Specialist
 

 Ability to work fully remote! Position Summary: Contract and Legal Affairs Specialist drafts, evaluates and negotiates contracts that are in compliance with company standards, industry best practices, reimbursement structure standards, and other key process controls. Experience drafting contracts from the beginning, as well as reviewing contracts for compliance and protection, is essential in this role. Responsibilities also include establishing and maintaining strong business relationships with network participants, ensuring the network composition includes an appropriate distribution of provider specialties and working collaborative with all departments and multiple lines of business to ensure all contract types meet relevant laws and regulations before the company commits to the agreement, and then monitors adherence to the contract's terms. Ability to work autonomously to draft and execute varied healthcare contracts. Maintains corporate legal functions including business licensing, trademarks, and insurance applications. A strong understanding of a corporate legal department and its operations, including litigation, contracting, and other areas.

Salary Range:$63,797.00 To 79,747.00 Annually

Apply Now!
 
Administrative Assistant, Medicaid Programs Colorado Springs, CO and ability to work from home 2-3 days/week.

Position Summary: Responsible for providing administrative support to the Director of Medicaid Programs including calendar support, meeting facilitation, note taking and development of meeting materials including excel documents and power point presentations. Provides project management assistance to execute the strategic plan. Also functions as the main point of contact for callers and visitors in the Colorado Springs office with the ability to work from home 2-3 days/week.

Salary Range:$19.1600 To 23.9500 Hourly

Apply Now!
08/27/2021
Supervisor, Care Coordination RN Supervisor, Care Coordination RN

Responsible for oversight and supervision of daily operations of Care Coordination Department, comprised of nurses and social workers. Care Coordinators provide services on behalf of primary care providers to patients in areas such as care planning, disease management, med reconciliation, behavioral health, social determinants of health and advance directives. The Supervisor of Care Coordination, functions as a subject matter expert within the Care Coordination team, PHP Departments and practices. At the direction of the Manager, may provide care coordination services. Collaborates with the Manager and Director of Care Coordination in planning and executing departmental initiatives.

Apply Now!
08/27/2021
Supervisor, Data Analytics
Denver & Remote

Ability to work partially remote plus a $2,500 sign-on bonus!

Position Summary: Responsible for overall management, planning, and direction of the functions of the CDS Department. This includes supervising, training, and developing analyst team; leading key team projects to manage and optimize processes for data validation, mining, modeling, and visualization/reporting. Oversees the development and implementation of quality controls and departmental standards to ensure accuracy of data and deliverables. Utilizes analytic insights to identify strategic opportunities and drive key business initiatives.

Salary Range:$81,014.00 To 101,267.00 Annually

Apply Now!
08/27/2021
Manager, Clinical Data Analytics Denver, CO

Responsible for the overall management, training, planning, and direction of the informatics team. Oversees the work and ensures the accuracy of the information provided by the team. Understands PHP's short-term and long-term business needs and develop data strategies and recommendations on how best to put data analytics to use. Able to interpret data and support the team to produce understandable and actionable reports. Apply proven communication skills, problem-solving skills, and knowledge of best practices to guide the team on issues related to the design, development, and deployment of reports and software systems. The manager must demonstrate an understanding of relational database structures and has extensive experience in writing and tuning SQL queries and writing stored procedures and report development in SSRS, Tableau, and/or Power BI. Must be comfortable working in a fast-paced and dynamic environment.

Ability to work partially remote plus a $2,500 sign-on bonus!

Apply Now!
08/27/2021
President and Chief Executive Officer   US - Open

America’s Physician Groups is one of our nation’s premier organizations leading the movement to transform American Healthcare. APG is a national association representing more than 335 physician groups in 44 states with approximately 170,000 physicians providing care to nearly 90 million patients. APG’s tagline, ‘Taking Responsibility for America’s Health,’ represents APG’s members’ vision to move from the antiquated, dysfunctional fee-for-service reimbursement system to a clinically integrated, value-based healthcare system where physician groups are accountable for the coordination, cost, and quality of patient care. APG has offices or staff in Washington, D.C, Los Angeles and Sacramento. It generates $8 million in annual revenues and is staffed by 15 employees.  

The APG Board is seeking an experienced and talented executive who is passionate about leading an association that is committed to transforming American Healthcare. As the lead spokesperson for APG, this leader will have the authenticity and credibility nationally to inspire, motivate, and influence others. He/she will be masterful in relationship building with the board, staff, members, government agencies, legislatures, insurance companies, and health systems. Qualified candidates will have ten years plus of experience in progressive healthcare leadership roles and will possess exceptional knowledge of value-based care and a deep understanding of what is needed to drive performance in value- and risk-based contracts.

Please send cover letter and resume to [email protected]

 08/17/2021
VP, CHS Operations - North Region Remote or Tampa, FL or Charlotte, NC

Collaborative Health Systems (CHS), a leading management services organization that partners with independent primary care physicians (PCP) as they move to value-based models, is seeking a leader with overall P&L responsibility for its north region. The individual will drive results across a diverse portfolio of value-based contracts. The position requires strong operational and strategic leadership as well as close engagement among PCP partners. Will work closely with national finance, actuary, clinical, operations and development teams to achieve CHS’s overall strategic objectives.

  • P&L responsibility for the North region of the United States
  • Oversee the development of policies and procedures for operational processes to ensure optimization and compliance with established standards and regulations.
  • Oversee the negotiation and administration of value based contracts to ensure a strong provider network.
  • Influence and drive network provider performance
  • Ensure IHPA clients access to quality of care and adherence to regulatory requirements.• Represent the organization in its relationships with all stakeholders, including health care providers, government agencies, trade associations, health plans, and similar groups.
  • Develop a sound short-and long-range plan for the organization.
  • Ensure the adequacy and soundness of the organization’s financial structure and review projections of working capital requirements.
  • Promote enrollment growth by supporting marketing event planning and execution.
  • Develop and manage network provider relationships.

Bachelor's degree in Business Administration, Finance, Accountancy or a related field. Master’s degree preferred. 9+ years of operations, management, or administration in the healthcare or insurance industry. Extensive experience in contracting, contract acquisition, operations management, and strategic planning and development. IPA experience preferred. Experience with value-based contracting preferred.

Apply Now! (see career home)
 08/17/2020
Financial Analyst - Value Based Care
Fort Myers/Remote

The Financial Analyst – Value Based Care supports the financial operations and analytical efforts of the fast-growing company's various value-based contracts ranging from MSSP ACOs, Medicare Advantage Plans, and Commercial ACOs. This position will collaborate with various payor partners and internal stakeholders to deliver enhanced performance on value-based contracts. Duties will include financial system development, financial operations process development, and process execution. Works closely with the company's value-based analytics, payor contracting, and finance teams to ensure appropriate and meaningful collaboration drives results. The position works on multiple projects as a subject matter expert in a fast-paced environment for the support of executive management, physicians, and other internal clients.

'Education and Experience

Minimum:

  • Bachelors
  • Required- 1+ years of experience working in a Financial Analyst or Business Analyst Role•Attention to detail
  • MS Office (Excel)
  • Critical thinking
  • Ability to work with technical and non-technical stakeholders
  • Desire to learn / Intellectual curiosity

Preferred:

  • 3+ years of experience working in Business Analyst or Data Analyst role at a healthcare provider
  • Coding skills (SQL)•BI tools (Tableau or PowerBI)
  • Healthcare system knowledge
  • Statistics (basic understanding)

Apply Now!

08/16/2021
Contract Manager Remote Flex - Occasional Travel to Maine Required

Community Care Partnership of Maine is looking for a Contract Manager! As Contract Manager, you will oversee all administrative components of CCPM contracts – everything from execution to negotiation to renewals. You will have a constant pulse on active licenses and agreements, managing contract relationships and details. We are looking for a highly organized, effective communicator who is skilled in collaborating across platforms to ensure contract operations are compliant and mission-focused. Ready to make amazing things happen?

Apply today!

08/0282021
Director of Quality and Care Management Coeur d'Alene, ID

Kootenai Health is hiring a Director of Quality and Care Management for Kootenai Care Network!

Do you thrive on analyzing and managing clinical and non-clinical Quality initiatives and activities within a clinically integrated health network to achieve transformational and sustainable improvements in outcomes? If so, our Director of Quality and Care Management is the perfect fit for you!

As the Director of Quality and Care Management, your core responsibilities include:

  • Leadership of clinically focused quality outcomes for value-based care programs including Medicare, Medicaid, other governmental, and Commercial health plans
  • Leadership of highly engaged chronic care management division deploying assigned, embedded, and/or independent chronic care management across more than 700 providers, 8 hospitals, and 60,000 covered lives under value-based agreements
  • Network dyad partner with physician and other provider leaders of committees including Quality, Primary Care Service Line, Pediatrics, OB/GYN, and Practice Leader Workgroups
  • Accountable for the development of target setting and action plan adoption to achieve contracted metrics and measurement of program outcomes for network primary, specialty, and facility services
  • Integrating quality outcome goals in KCN programming and outreach
  • Providing leadership and support to KCN Medical Director and Chair, Quality/Health Information Technology Committee, and others supporting the work of Utilization Management and Care Management throughout the network of providers for the achievement of sustained quality
  • Acting as a resource to the President of Kootenai Care Network for support of companywide quality initiatives

Learn more and apply today!

07/29/2021 
President, Kootenai Care Network
Coeur d'Alene, ID

Kootenai Health in Coeur d'Alene, ID is seeking the next President of their Clinically Integrated Network - Kootenai Care Network (KCN). KCN has developed sophisticated population health capabilities to successfully manage risk and deliver greater value to the people they serve of Northern Idaho. Today KCN has over 700 providers and 8 hospitals with 60,000 covered lives.

Kootenai Health is consistently recognized as a Gallup Great Workplace, with Magnet Hospital designation since 2006 and is a member of the Mayo Clinic Care Network. Today, the health system has 4,000 employees, over $700 million net revenue and an "A" rating by S&P.

The ideal candidate will have prior experience with a clinically integrated network, or leading value-based care initiatives in an integrated delivery system, health plan or medical group. The President will oversee operations of the network, payer contracting, data analytics and care management infrastructure in evolving payments models that include global risk capitation.

Expressions of interest or questions should be submitted to Mark Andrew or call (949) 797-3528.

0728/2021
Director of Performance Insights New Orleans, LA

Education

Required - Bachelor’s degree in business, analytics, healthcare, or related field.
Preferred - Master’s degree.

Work Experience

Required - 8 years related work experience; 3 years of supervisory.

Preferred

  • 10 years of related work experience;
  • 5 years of supervisory experience;
  • 3 years of experience leading value-based strategy for a clinically integrated network or health plan.

Knowledge Skills and Abilities (KSAs)

  • Strong leadership and the ability to drive strategy & engagement.
  • Analytical skills and logical thought processes to help develop practical solutions to problems.
  • Ability to translate data into a cohesive story.
  • Strong verbal and written communication skills to effectively flex the style and content to reach varied audiences.
  • Proficiency in using computers, software, and web-based applications.
  • Effective verbal and written communication skills and the ability to present information clearly and professionally.
  • Strong interpersonal skills.

Job Duties

  • Leads a team that spans from strategy and analysis through execution.
  • Drives change, working across varied departments and organizations to ensure performance improvement and quality metrics are used to drive improvement in patient outcomes.
  • Provides analysis and design of projects with a meaningful impact on quality and financial performance
  • Analyzes complex clinical and financial data from multiple sources
  • Provides recommendations to leaders to improve quality and utilization metrics related to medical action planning and risk optimization.
  • Evaluates assigned business processes, challenges, and goals to make recommendations to ensure those goals are achieved and challenges are overcome.
  • Coaches performance improvement team.
  • Deciphers large amounts of information to uncover and understand the underlying cause and makes recommendations for improvement.
  • Performs other related duties as assigned.

Apply Now or send your resume to [email protected]

 07/26/2021
Executive Director, Network Engagement and Performance Altamonte Springs, FL

The Executive Director, Network Engagement and Performance provides leadership, strategic direction, and operational execution to AdventHealth Population Health , the Clinically Integrated Network (CIN) for Central Florida Division (CFD) Population Health is defined as “A model that delivers high quality, people-centered care through highly efficient and effective processes at every venue of care throughout a highly aligned, meaningfully connected ecosystem throughout a patient’s lifetime.” This position is accountable for the strategy and operational delivery of established structures, protocols and processes that drive the performance of the network in our value-based arrangements defined as lowering total cost of care below contracted targets and exceeding quality and experience requirements. Drives performance in quality, utilization, and service delivery expectations which include connected, convenient and complete care. Accountable for creation of, deployment of and operational execution of protocols and systems including but not limited to analytics, care management, meaningful interoperability, communications, education, and CDI. Adheres to the AdventHealth Corporate Compliance Plans and to all rules and regulations of applicable local, state, and federal agencies and regulatory bodies. Actively participates in outstanding customer service and accepts responsibility for maintaining relationships that are equally respectful to all.

Apply Now!

07/22/2021
 Data Analyst / Senior Data Analyst  Remote

Integrated Care Solutions (ICS) is a care management company who seeks to transform healthcare by providing patient’s navigating through the healthcare system a superior experience and the highest quality outcomes by providing exceptional care management and seamless coordination of care throughout the post-acute care and home and community-based care continuums within the lowest cost possible.

Responsibilities

  • Conduct data analysis and generate reports to drive both internal and external initiatives.
  • Interpret reporting to provide insights and actionable intelligence to internal and external consumers of data.
  • Support the management and development of our care management software platform and related analytics/reporting.
  • Draft engaging and concise PowerPoint presentations to provide data analysis and strategic recommendations to clients.
  • Identify ways to improve and expand data use, reporting, and analytics to support internal and external initiatives.
Qualifications
  • An undergraduate or graduate degree in business, economics, public health, public policy, statistics, mathematics, or other related field
  • At least 2 years of relevant full-time work experience
  • Familiarity with policy issues and reimbursement models for acute and post-acute care providers 
Preferred Skills and Competencies
  • Exceptional analytical, problem solving, and quantitative skills; Great attention to detail
  • Experience with healthcare claims and/or medical record data analysis
  • Excellent PowerPoint skills and ability to develop senior executive-level presentation materials
  • Advanced Excel skills and comfort working with large datasets, financial modeling experience a plus
  • Experience with SQL and Power BI, Tableau, or other business intelligence software
  • High level of initiative, quick learning ability, creativity, and resourcefulness

Please submit resume to Colin Yee.

07/16/2021
Manager, Population Health and Value Based Care San Antonio, TX

UT Health San Antonio is hiring a Manager of Population Health and Value Based Care to oversee the Quality Department’s care management services, including case managers and community health workers. The manager ensures patients receive the proper care and service from the case manager they are assigned to.  

Job Duties 

  • Reviews case manager and community health worker files, case notes, outcomes, and logged progress to ensure patients are properly cared for and tracked. Reviews and audits case management services provided to patients to ensure standardized delivery of such services. Provides feedback and corrective action reports to staff.
  • Helps to coordinate and oversee therapies, evaluations, and treatment objectives that are developed by the case manager in partnership with the patient’s clinician.
  • Development and implementation of systems, in alignment with UT Health San Antonio’s policies and procedures and principles, to enhance clinic operational efficiency and delivery of services to patients. This includes identifying a decreasing unnecessary redundancy in clinical care management processes. Assists with overseeing daily workflow of the Quality staff in the clinic to ensure established clinic workflows are being followed.
  • Provides ongoing staff training within a specific office regarding the technical and patient management dimensions of UT Health San Antonio’s management system, including effective integration of information, technology, and treatment.
  • Provides senior management with reports and analysis of case management reports.
  • May be involved with providing case management services directly to patients.
  • Assists with the implementation of policies and procedures regarding medical case management and provides leadership for staff by modeling expectations and behaviors.
  • Maintains compliance with federal and state regulations and contractual agreements.
  • Coordinates and communicates medical service functions with other departmental functions.
  • Assists staff with computer systems issues related to case management.
  • Conducts telephonic review of cases with clinicians, hospitals, and other providers.
  • Responsible for staff scheduling, employee evaluations and resolving staff conflicts. Assigns cases, maintaining appropriate staffing ratios. Responsible for hiring staff and checking credentials, license requirements, and certifications.
  • Assures that documentation meets guidelines for timeliness and accuracy.
  • Assures that case plan goals, permanency goals for patients, and other appropriate services are established and achieved in a timely manner.
  • Oversees case managers as they develop plans for UT Health San Antonio and Regional Physicians Network patients. This includes, but is not limited to, setting schedules and routines, arranging resource, coordinating services, providing advocacy, evaluating treatments, intervening in crisis, and providing general support.
  • Meets regularly with CVO/ACO CMO to provide updates on activities in Quality and Care Management, assists in communications, and assists as needed in organization and tracking of Population Health and Value Based Care activities.
  • Network Development, Physician Recruiting and Retention as directed by CVO/ACO CMO.
  • Performs other duties as assigned.  

Knowledge, Skills, and abilities 

  1. Knowledge: Ability to demonstrate in-depth knowledge of concepts, practices and policies with the ability to use them in complex varied situations.
  2. Leadership: Ability to direct and contribute to initiatives and processes while creating a collaborative and respectful team environment and improving workflows.
  3. Managerial/Supervisory: Knowledge of business and management principles involved in planning, resource allocation, human resources modeling, leadership technique, production methods, and coordination of people and resources.
  4. Organization: Demonstrated ability to organize and coordinate work within schedule constraints and handle emergent requirements in a timely manner.
  5. Detail oriented with meticulous planning, organizational and negotiating skills.
  6. Ability to lead, direct and contribute to initiatives and processes within the institution while creating a collaborative and respectful team environment and improving workflows.  

Education 

  • Bachelor's degree in a work-related field/discipline from an accredited college or university is required
  • RN/APN degree from an accredited university is required  

Experience 

  • Five (5) years of progressively responsible and directly related work experience is required.  

Licenses and Certifications 

  • Current RN Licensure as a Registered Nurse in the State of Texas and/or Compact State Licensure
  • Current Certified Case Manager Certification

Apply Now!

07/09/2021
Director of Payor Strategy and Program Performance Coeur d'Alene, ID Kootenai Health, located in Coeur d’Alene, ID, is hiring a Director of Payor Strategy and Program Performance! If you aspire to identify and develop contemporary contracting strategies for Kootenai Health and Kootenai Care Network with a predominant focus on value-based care while transitioning from traditional contracting methodologies - Kootenai Health is seeking your visionary leadership to partner with the Kootenai Care Network! As the Director of Payor Strategy and Program Performance, your core responsibilities include:
  • Identifying and developing strategies for payer partnerships as well as network expansion influenced by strategic contracting relationships
  • Having responsibility for payer relationship management, contract terms and conditions supported by pricing strategy, analytics, and impact plans
  • Directing payer contract negotiations with input from executive leadership of Kootenai Health and Kootenai Care Network in support of population health initiatives
  • Working with internal and external analytical teams and actuaries to ensure support for contract negotiations, performance, population health financial modeling, report production, and database management.
To be successful in this role, you will need:
  • BS in Finance/Accounting, business, or healthcare-related field required. Master’s degree preferred
  • 7 years relevant experience at an insurance company or healthcare environment required
  • Experience in payer contract negotiation
  • Excellent analytical skills and ability to manipulate large data sets from multiple systems
  • Familiarity with current common coding practices including CPT4, ICD9CM, and DRGs as well as current Medicare reimbursement methodologies and quality initiatives
  • Knowledge of pricing, healthcare finance, managed care, provider incentives, and risk contracting required
  • Knowledge of quality and outcome measures aligned with health plan scoring and ratings, including STAR ratings
  • Understanding of healthcare expense risk for populations, its components (unit price and frequency), and drivers
Kootenai Health will ensure your success by providing you a robust leadership orientation program, access to Organizational Development, and co-workers who are knowledgeable and invested in your success. Kootenai Health has a lot to offer you, including:
  • A passionate, knowledgeable Kootenai Care Network Team.
  • Expanding department with room for future career development and continuous learning opportunities.
  • Magnet Status - Kootenai has maintained MagnetTM status since 2006. This designation is nursing's top honor, accepted nationally as the gold standard in nursing excellence!
  • Level II Trauma Center- Kootenai Health has achieved a Level II Trauma designation, verified by the American College of Surgeons Committee on Trauma.
  • Mayo Clinic Care Network- Kootenai Health is a member of the Mayo Clinic Care Network (MCCN). As part of the Mayo Clinic Care Network, Kootenai Health staff have access to Mayo Clinic’s knowledge and expertise.
  • Gallup Great Workplace Award - This award recognizes companies for their extraordinary ability to build an engaged workplace culture.
Kootenai Health has a solid reputation in the Pacific Northwest and has a rich history that spans nearly 60 years of innovation, achievements, and benchmarks in healthcare. The organization provides a comprehensive range of medical services, our main campus is located in Coeur d’Alene, Idaho, and includes a 330-bed community-owned hospital. Kootenai Health is accredited by DNV and holds Magnet Designation for nursing excellence. We have been recognized among large employers as the No. 1 Best Place to Work in Healthcare by Modern Healthcare magazine, and are regularly recognized by Cleverly and Associates for providing value to our community. We offer an excellent tuition reimbursement program, wellness program, and ongoing educational classes to all of our employees. If you want to love where you work and live, check out Kootenai Health. As your next employer, we are excited to offer you:
  • 100% employer-paid health insurance premiums for full-time employees. Part-time employees pay only a small portion a month for medical, dental, and vision coverage
  • Access to tuition reimbursement
  • 457 investment plan through Fidelity with a match of 3-6% based on years of service and a defined contribution account which puts 2% of annual income into a retirement account
  • Employee child daycare - within walking distance
  • On-site learning through the Organizational Development department and teaching modules
  • Competitive salaries
  • Robust and incentive-driven Wellness Plans
  • Full-spectrum employee reward, recognition, and retention programs, including outstanding employee development, training, and educational opportunities
  • And much more!

If you have questions, please contact Kelly Wolfinger.  We look forward to getting to know you better! 

Apply Now! 

07/02/2021