Hospital Value-Based Programs Lead

CareSource; Las Vegas (NV); On-site; USD 83,000 - 133,000; Full time

Job summary

CareSource in Nevada is seeking a Hospital Value-Based Provider Programs Manager to lead the design and execution of value-based payment initiatives across the market. You will drive provider engagement, monitor program performance, and ensure alignment with contractual quality targets and financial objectives.

The role requires broad experience in value-based reimbursement, provider contracting, and population health, as well as the ability to collaborate with hospitals and providers to achieve

Qualifications

• Bachelor's degree in Business Administration, Healthcare Administration, Public Health, Finance, Nursing, or related field.
• Five (5) years of experience in value-based reimbursement/payment design, methodologies and/or VBR contracting, provider contracting, provider performance, managed care operations, population health, or healthcare quality required.

Responsibilities

• Lead the implementation, monitoring, and optimization of hospital value-based payment programs, ensuring contractual performance expectations, quality outcomes, and financial targets are achieved.
• Develop and execute strategies to maximize quality withhold performance and return quality incentive payments to the market health plan through provider engagement, education, performance monitoring, and corrective action planning.
• Serve as the market subject matter expert for hospital value-based payment programs, providing leadership and operational guidance to internal stakeholders and contracted provider organizations.
• Oversee additional programs, including provider participation, regulatory compliance, stakeholder engagement, reporting, and program performance monitoring.

Skills

Analytical skills

Communication

Project management

Healthcare payer knowledge

Education

Bachelor's degree in Business Administration/Healthcare/Finance

Tools

Microsoft Office

Job description

CareSource in Nevada is seeking a Hospital Value-Based Provider Programs Manager to lead the design and execution of value-based payment initiatives across the market. You will drive provider engagement, monitor program performance, and ensure alignment with contractual quality targets and financial objectives.

The role requires broad experience in value-based reimbursement, provider contracting, and population health, as well as the ability to collaborate with hospitals and providers to achieve