Network Performance Monitoring Jobs in Louisiana

Summary:

The VBC Performance Consultant is responsible for supporting the care management teams in solving complex problem focused on improving cost and quality performance on value-based contracts or alternative payment programs. This includes the CHRISTUS Health CIN/ACO, Health Plan, and other initiatives as they arise.

Responsibilities:

• Meets expectations of the applicable OneCHRISTUS Competencies: Leader of Self, Leader of Others, or Leader of Leaders.
• In coordination with Manager, VBC Performance responsible for monitoring, analyzing and synthesizing trends across value-based care contract key indicators and contractual commitments to ensure network performance engaging Network and care management leadership with strategic planning to ensure success in contracts.
• Analyzing and synthesizing data (e.g., population health utilization, cost, benchmarking, quality reports) to communicate contract performance and advise on next steps required to achieve metrics to support program planning.
• Supporting the development of quantitative and qualitative evaluations and scenario modeling for contract/program participation in order to generate recommendations to leaders within and beyond Population Health Services; these evaluations will include operational feasibility, financial implications (ROI), physician impact, and general pros and cons.
• Supporting cross-functional teams in initiatives, implementation and programs to help to achieve contract targets.
• Documenting standard work for successful initiatives and building processes to ensure program sustainability.
• Analysis of relevant national programs & accreditations such as the Center for Medicare/Medicaid Services (CMS): Merit-Based Incentive Payment System (MIPS) and, National Committee for Quality Assurance, etc. for changes that may impact the organizations measures or programs.
• Serving as key point of contact to payers around value-based contracts.
• Serves as subject matter expert and interpreter of value contracts and programs to support the description of what we need to accomplish and subsequent stakeholder decisions.
• Analyze and communicate relevant policy updates in the value-based payer space, including Medicare, Medicare Advantage, commercial and Medicaid.
• Subject matter expert to advise how program and policy changes would impact CHRISTUS Health CIN day-to-day operations and performance.
• Lead work with key stakeholders to coordinate end to end VBC Quality performance monitoring/data submission coordination.
• Project manage and work with key stakeholders to support end to end implementations of key initiatives supporting care delivery.
• Identifies and participates in development of key Pop Health/ACO Education to support CHRISTUS Health employed or affiliated physician network.
• Able to think with an enterprise mindset and to continuously challenge the status quo.
• Has strong presentation skills with the ability to present to leadership.

Job Requirements:

Education/Skills
• Associate’s degree required
• Bachelor's degree in healthcare or related field preferred

Experience
• Associate’s degree plus 5 years of experience, or bachelor’s degree plus 3 years of experience working in data analysis with expertise in Medicare, Medicare Advantage, Medicaid, and commercial required
• 3 years in healthcare and/or experience in implementing continuous improvement methodologies required, with the increasing scope of complexity supporting the total cost of care reduction and HEDIS STAR rating performance required
• Experience supporting value-based care performance & strategy– improving outcomes while managing the total cost of care required
• Experience synthesizing complex information and applying good judgment to possible impacts and solutions required
• Demonstrated expertise in Medicare Advantage required
• Experience in a highly complex integrated health system or payer environment is required
• Experience in Population Health Management, such as HEDIS/STARs, CMS Quality measures, and Cost utilization programs required

Licenses, Registrations, or Certifications
• LVN/LPN or RN preferred

Work Schedule:

5 Days - 8 Hours

Work Type:

Full Time