Value-Based Care Program Manager
Our Mission: Provide the best value in health insurance and related health services to improve the quality of life for Arizonans.
Inspire health in Arizona as the trusted leader in delivering affordable, innovative healthcare solutions.
Our Benefits: Our benefits provide work-life balance and the flexibility you need to be your best. We offer comprehensive medical, dental, and vision coverage; a 401K savings plan; paid holidays and vacations; and much more!
Position Purpose: Reporting to the Chief Operating Officer, the Value Based Care Program Manager will manage all aspects of existing and new value-based programs. This position is responsible for the development and execution of strategic goals focused on transforming the delivery of care to improve patient experience, quality, outcomes, and reduce the total cost of care, while ensuring ongoing compliance and operational effectiveness. Works both independently and collaboratively with all health plan functional areas to ensure regulatory and health plan goals are met.
- Oversee strategic planning for evolving value-based care work consistent with organizational and regulatory priorities.
- Monitors and reports on key performance indicators.
- Partners with key organizational stakeholders to establish and integrate programs, networks, or services necessary to successfully manage value-based contracts through full implementation and/or pilots.
- Translates strategy to operational tactics through focused efforts/actions that will have the greatest strategic impact, including the education of management and staff on program relevancy.
- Lead and develop content for key committees that oversee performance, projects and programs supporting value-based care, including interfacing with external partners.
- Create management processes to drive accountability on key metrics and develop new metrics to guide strategic and operational decision-making.
- Coordinate with analytics team to develop and continually improve reporting tools to evaluate and communicate actionable reporting related to quality, risk, and cost efficiency opportunities for internal and external stakeholders.
- Identify or develop care transformation solutions drawing from national best practices, analytics, personal expertise, and creativity to deliver value-based programs.
- Responsible for being a care transformation change agent through strong partnerships and collaboration with internal customers, providers, clinicians, and VBC stakeholders.
- Provide coaching and oversight to key team members for identified areas of operation.
- Ensure compliance with regulations and governing laws including Federal and State governmental payers. Review, evaluate and summarize rules, regulations and contracts relating to all current and proposed value-based programs.
- Partner closely with operations, analytics, and clinical leadership, including all areas of population health operations (not limited to care management, quality, utilization management, network strategy, patient engagement, technology, performance monitoring, finance, etc.) to assure all are informed, working as one unified organization and aware of deadlines, requirements and their role within the value-based program infrastructure.
- Other duties as assigned.
Education / Experience / Other Requirements
- Bachelors in business, science, finance, economics, public health, health care management, psychology, nursing or related field
Years of Experience:
- A minimum of 2 years of population health, value-based care, managed care, quality/process improvement, nursing leadership or project management, preferably within a managed care or provider practice setting
- Direct value-based care/population health/payment & care transformation expertise
- Comprehensive understanding of and significant experience using Microsoft Excel
Skills & Abilities:
- Project management, including strong work ethic, attention to detail, time management
- Ability to prioritize, problem solve, think critically, retain new information and willingness to learn
- Ability to efficiently manipulate and manage large data sets
- Strong attention to detail, organizational skills, and verbal and written communication skills
- Outstanding interpersonal skills, ability to establish a trusting rapport with individuals at all levels, internally and externally
- Creativity and innovation, risk analysis, analytical rigor, and implementation expertise
- Ability to maintain confidentiality
- Maintain a calm and collected presence while addressing the concerns from an internal and external customer
- Efficiently manage multiple tasks, with varying degrees of priority, at the same time