Manager, Value-Based Care Programs

MUSC Health; Charleston (SC); On-site; USD 80,000 - 120,000; Full time

Job summary

MUSC Health is seeking a Manager for Value-Based Care Programs to oversee compliance, operations, and financial performance across multiple value-based programs. This role requires a strategic mindset and strong leadership skills to manage a team and foster partnerships within the healthcare sector.

Qualifications

• 8 years progressive work experience and 3 years management experience required.
• Must have experience with value-based care operations and financial performance.

Responsibilities

• Oversee program operations, compliance, and financial performance.
• Lead strategic initiatives for population health management.
• Cultivate partnerships with government agencies and commercial payers.

Skills

Project Management

Financial Analysis

Regulatory Compliance

Stakeholder Engagement

Education

Bachelor's Degree

Job description

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Job Description Summary

The Manager for Value-Based Care Programs reports directly to the Administrator of MUHA Population Health with a dotted line to the Chief of Population Health/Executive Director MUSC Health Alliance. The role acts as a strategy and subject matter expert, and provides direct oversight and supervision to the value-based care program coordinator/project management team. This team is responsible for leading existing value-based program operations and launching new program opportunities within the MUSC Health portfolio. The Manager is entrusted with Value-Based Care Program Oversight, Operations, Financial Performance and Federal Regulatory Compliance across all existing and emerging contracts. The Manager also serves as the liaison for MUSC Health leadership teams and Population Health analytics, fostering strong relationships and ensuring alignment with organizational goals as new performance opportunities emerge.

Job Description Summary

The Manager for Value-Based Care Programs reports directly to the Administrator of MUHA Population Health with a dotted line to the Chief of Population Health/Executive Director MUSC Health Alliance. The role acts as a strategy and subject matter expert, and provides direct oversight and supervision to the value-based care program coordinator/project management team. This team is responsible for leading existing value-based program operations and launching new program opportunities within the MUSC Health portfolio. The Manager is entrusted with Value-Based Care Program Oversight, Operations, Financial Performance and Federal Regulatory Compliance across all existing and emerging contracts. The Manager also serves as the liaison for MUSC Health leadership teams and Population Health analytics, fostering strong relationships and ensuring alignment with organizational goals as new performance opportunities emerge.

Entity

Medical University Hospital Authority (MUHA)

Worker Type

Employee

Worker Sub-Type

Regular

Cost Center

CC002347 SYS - Population Health Program

Pay Rate Type

Salary

Pay Grade

Health-32

Scheduled Weekly Hours

40

Work Shift

Job Description

• Singular payer/agency point of contact for program compliance, audit response, queries and applications. Must be able to consolidate responses and inputs from all areas of the Health System and Health Alliance while maintaining strict adherence to program timelines.
• Health System focal point for value-based care and grant-funded Population Health activities. Must be able to effectively project manage new initiatives across a matrix of stakeholders and then transition to program management for on-going success.
• Strengthen and sustain partnerships with government contracting agencies, commercial payers and emerging partners
• Lead Medicare Shared Savings Program strategy operations and reporting to promote accountability for patient care coordination and encourage investment in high-quality, efficient services
• Lead and organize Health Alliance Finance Contracting, Health Alliance Executive Committee, Health Alliance board meetings, Joint Operating Committee operations, ensuring effective communication and collaboration
• Lead Population Health Joint Operating Committee workflow, next-step action items, program status, issue management, project management and analysis
• Lead Health Alliance and Population Health strategic initiatives and plans, ensuring timely and successful execution
• Lead Health Alliance Compliance Committee efforts, program audits and annual reviews
• Work closely with ICCE and physician leaders to develop strategies, draft value-based care and Value Institute SDOH grant proposals/reporting, and execute new contracts
• Lead Health Alliance Compliance Committee operations and annual program evaluations
• Lead, manage and develop value-based care financial reporting for Milliman analytics to drive data-based solutions across the program portfolio
• Lead contract and vendor operations between Population Health and MUSC Legal within Symplr and Axiom
• Oversee team of 4-8 program coordinators and project managers who lead 13+ existing value-based programs and 10+ emerging program opportunities across the MUSC health system, covering 200,000+ patient lives
  
  

Additional Responsibilities Include

• Oversee program development, implementation, and evaluation for various Health Alliance initiatives, including operational improvement projects, lead interdisciplinary grant proposal drafts and managing timelines of program deliverables including: Quality Achievement Program, Centene, Select Health, Blue Cross Cooper/PCMH, CMS Models including: Enhancing Oncology Model, Kidney ETC, GUIDE, MSSP (PY 2025), TEAM (PY 2026)
• Contribute to the development of strategic plans, initiatives and KPI development to enhance Population Health and Health Alliance operations
• Identify and implement process improvements and contract performance opportunities to optimize Population Health and ACO performance, based on VBC Savings’ analytics
• Provides consultation to MUSC Health leadership and communicates with involved personnel about regulatory requirements, implications to the value-based environment and strategies to reliably achieve compliance across all programs
• Lead Population Health internal communications on quarterly Staffbase newsletter and annal report basis to highlight progress across the enterprise
  
  

Additional Job Description

Education: Bachelor's Degree or Equivalent Work Experience: 8 years progressive work experience and 3 years management experience

If you like working with energetic enthusiastic individuals, you will enjoy your career with us!

The Medical University of South Carolina is an Equal Opportunity Employer. MUSC does not discriminate on the basis of race, color, religion or belief, age, sex, national origin, gender identity, sexual orientation, disability, protected veteran status, family or parental status, or any other status protected by state laws and/or federal regulations. All qualified applicants are encouraged to apply and will receive consideration for employment based upon applicable qualifications, merit and business need.

Medical University of South Carolina participates in the federal E-Verify program to confirm the identity and employment authorization of all newly hired employees. For further information about the E-Verify program, please click here: http://www.uscis.gov/e-verify/employees

Seniority level

• Seniority level

  Director

Employment type

• Employment type

  Full-time

Job function

• Job function

  Project Management and Information Technology

• Industries

  Hospitals and Health Care

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