General Summary
Responsible for advancing WellSpan's leadership in population health and value-based care through management of contractual arrangements with WellSpan's strategic partners and government payors to develop, launch, and administer accountable care programs and value-based care payment models. This position provides team-based end-to-end consulting and management of program application and onboarding processes, program compliance and regulatory requirements, ongoing development and deployment of performance maximization strategies pertaining to program attribution, quality maximization, cost and utilization management, coding and documentation, and network keepage in partnership with WellSpan's strategic partners.
Duties and Responsibilities
Remote Work Capable
Essential Functions:
The successful candidate will have a strong management skillset with accountability for multiple complex, continuous improvement initiatives simultaneously tied to regulatory or payor partner deadlines.
Develops and maintains niche expertise in governmental payment models to optimize performance under value-based care programs. Monitors changes in federal and state laws and regulations that impact programs designed by the Centers for Medicare and Medicaid Services (CMS) and state agencies.
Maintains subject matter expertise in value-based care including expert knowledge of regulatory requirements of Medicare ACOs, healthcare industry and marketplace trends related to value, public reporting of clinical performance data, and targeted areas for value-based care improvement.
Manages accountable care strategic partnerships with fidelity to contractual obligations and program regulatory requirements with a focus on continued partnership success and advancement of the relationship with the strategic partner organization.
Provides support to the WellSpan Provider Network to assure participants have the requisite information and clinical programs for the efficient delivery of healthcare services to defined populations while meeting and exceeding required key performance indicators of these programs.
In collaboration with strategic partners, consults and facilitates the progress of clinical and operational initiatives designed to improve quality, improve affordability, and reduce medically unnecessary, avoidable utilization of health care services, improve network keepage, improve accuracy of coding and documentation, and manage program attribution among populations in value-based care and population health programs.
Maintains expertise into the various forms of utilization of health services used by accountable care populations and, with direction from WellSpan's Director of Network Development and Senior Director of Care Transformation, develops, deploys, and facilitates efficient use of reports of these utilization and quality of care patterns by WellSpan's clinical and operational entities and the WellSpan Provider Network.
Regularly navigates a highly matrixed professional environment of managers, leaders, and other stakeholders within WellSpan and strategic partner organizations with a collaborative leadership approach to advance WellSpan's leadership in population health and value-based care.
Provides general support for enterprise-wide strategies linked to WellSpan's journey to value.
Successful relationship management with strategic partners, strong people skills, a collaborative leadership approach, and ability to navigate a highly matrixed professional environment are critical to the success of this role.
Common Expectations:
Continuously assesses and maximizes the performance of value based care programs.
Maintains professional growth and development through seminars, workshops, CMS learning collaboratives, and professional affiliations to keep current with latest trends in field of experience.
Provides outstanding service to all customers; fosters teamwork; and practices fiscal responsibility through improvement and innovation.
Travel Requirements:
Estimated Amount: 5% - Some limited travel
Qualifications
Minimum Education:
Bachelors Degree In a healthcare, healthcare policy, public health, public policy, or data analytics. Required or
Masters Degree Or comparable graduate degree. Preferred
Work Experience:
1 year Experience in Medicare accountable care management/evaluation and data analysis. Required or
3 years Experience in Medicare accountable care management/evaluation and data analysis. Preferred
Knowledge, Skills, and Abilities:
Minimum Field Of Expertise: Previous experience in governmental or commercial value-based care programs.
Understanding of the population health and accountable care contracting relationships between payors and providers. Solid understanding of patterns of chronic disease and measurements of performance related to the best management of these conditions.
Proficiency in use of Excel and claims data within population health functions
Understanding of regulatory environment as it relates to value based programs
Computer management skills including database administration, management of contracts with IT vendors, and project management related to data management
Excellent communications and advanced computer skills necessary for analysis and reporting of results
General understanding of regulatory and government agencies for healthcare
Benefits Offered:
Comprehensive health benefits
Retirement savings plan
Paid time off (PTO)
Education assistance
Financial education and support, including DailyPay
Expanded Paid Parental Leave
For additional details: Benefits & Incentives | WellSpan Careers (joinwellspan.org) (https://www.joinwellspan.org/benefits/)
Quality of Life
Founded in 1741, the city of York is considered by many as the first capital of the United States. The Articles of Confederation were signed by the Second Continental Congress here in 1777. Its beautifully restored historic district is an architectural treasure. While York retains its farming and manufacturing heritage, at its heart York is a thriving cultural community that has attracted creative talent and innovative entrepreneurial investors from across the nation.
Life in York County offers affordable housing, options for higher education, a thriving arts and cultural community, historical attractions, parks and recreational resources, semi-professional baseball team, fine dining and more - within an easy drive of major East Coast cities.
York County residents can find local employment in healthcare, manufacturing, technology, agricultural and service sectors. (Patient population: 445,000)
WellSpan Health is an Equal Opportunity Employer. It is the policy and intention of the System to maintain consistent and equal treatment toward applicants and employees of all job classifications without regard to age, sex, race, color, religion, sexual orientation, gender identity, transgender status, national origin, ancestry, veteran status, disability, or any other legally protected characteristic.
