Job Type:
RegularScheduled Hours:
40Job Summary:
Reports to the Vice President of Clinical Transformation. The Director of Value Based Performance is primarily responsible for developing and implementing processes and procedures within St. Elizabeth Physicians to improve organizational performance on selected value-based contracts driven by quality, utilization, and efficiency metrics. Using a combination of clinical, business, and analytic skills, the Director leads the development and implementation of value-based care strategy, services evolution, strategy implementation, and technology innovation for accountable care services.The Director and their team work closely with Care Coordination, Process Improvement, and Information Systems to optimize performance specific to organizational goals, payer contracts, total cost of care, governmental initiatives, and other assigned duties. The position supports both clinical and administrative departments, including the St. Elizabeth Provider Network (SEPN) and Healthcare Solutions Network (HSN), to design tactics that efficiently support and care for the community served.
This individual will consistently present a positive impression to patients, providers, and other visitors, both in person and on the phone. The Director must be a loyal team player who can work autonomously, demonstrating independent thinking, judgment, discretion, confidentiality, decision-making, and problem-solving skills, even in stressful situations.
Job Description:
BENEFITS:
- Paid Time Off
- Medical, Dental, and Vision
- 403b with Match
DUTIES & RESPONSIBILITIES:
- Determines Value Based Performance initiatives in collaboration with the Clinical Director of Value Based Performance and the Clinical Director of Quality.
- Utilizes data from payer and internal sources to identify opportunities for improvement of organizational performance on quality and utilization metrics.
- Collaborates with Coding department to enhance and maintain provider expertise in Hierarchical Condition Category (HCC) coding.
- Evaluates organizational, practice, and individual provider performance to organizational goals, payer contract goals, and governmental initiative goals. Educates organization and system on Value-Based Initiatives
- Works closely with system-level contracting resources to assist in structuring optimal payer contract elements.
- Oversees the development and implementation of action plans at organizational, divisional, practice, or individual levels to drive improvement.
- Oversees Ambulatory Pharmacy resources in value-based performance efforts, including utilization initiatives and the Complex Case Review program.
- Collaborates with operational leaders and communicates with providers on data, including education on data and action plans for improvement.
- Serves as a liaison with St. Elizabeth Healthcare leadership on initiatives to improve total cost of care and utilization metrics.
- Works with external entities to facilitate public reporting and quality improvement.
- Performs other duties and responsibilities as assigned.
REQUIRED SKILLS AND KNOWLEDGE:
- Ability to manage and prioritize multiple tasks, knowledge of Microsoft Excel, Word, Visio, Outlook, and PowerPoint.
- Must have excellent organizational skills and be able to work professionally with providers, hospital administration, SEP employees, and the public.
OTHER REQUIRED SKILLS AND KNOWLEDGE:
- Knowledge of various healthcare plans and modeling.
- Extensive knowledge of a variety of vendor software programs specific to quality and cost management.
- Managerial experience required.
- Experience in developing improvement plans and measurable goals.
- Experience in directing and assisting others in stressful situations in a calm and confident manner.
YEARS OF EXPERIENCE:
- Minimum: 5+ years in health care, at least 3 of which must have been in a leadership capacity, and 3 years as an RN or PharmD
EDUCATION:
- Bachelors degree in health profession, administrative, or related discipline.
LICENSES & CERTIFICATIONS:
- Required: Valid Drivers License, RN License or PharmD
FLSA Status:
ExemptRight Career. Right Here. If you have a passion for taking care of the community and are interested in Healthcare, you will take pride in the level of care we provide at St. Elizabeth. We take care of patients and each other.
