Nevada Market Lead - Hospital Value-Based Programs

CareSource; Carson City, Northern (NV, KY); Hybrid; USD 83,000 - 133,000; Full time

Job summary

CareSource in Nevada seeks a Hospital Value-Based Provider Programs Manager – Markets to lead the design, implementation, and oversight of hospital value-based payment initiatives within the market. The role drives performance, quality outcomes, and provider engagement while aligning with state health plan contracts and strategic priorities.

The position requires a Bachelor’s degree and 5 years of related experience in value-based reimbursement, provider performance, or managed care operations.

Qualifications

• Bachelor's degree required in a relevant field; equivalent experience may be accepted.
• 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.
• Experience with hospitals, health systems, physician organizations, or Accountable Care Organizations (ACO) required.
• Medicaid Managed Care experience preferred.
• Experience leading market-based provider incentive, quality, or value-based payment programs preferred.

Responsibilities

• Lead the implementation, monitoring, and optimization of hospital value-based payment programs to meet contractual performance, quality outcomes, and financial targets.
• Develop strategies to maximize quality withhold performance and return incentive payments through provider engagement and performance monitoring.
• Serve as market SME for hospital value-based payment programs and guide internal stakeholders and providers.
• Oversee additional programs including provider participation, regulatory compliance, stakeholder engagement, reporting, and performance monitoring.
• Engage with providers and internal partners to identify opportunities for care gap closure and improved outcomes.

Skills

Communication skills

Analytical skills

Teamwork

Project management

Microsoft Office

Education

Bachelor's degree in Business Administration, Healthcare Administration, Public Health, Finance, Nursing, or related field

Tools

Microsoft Office

Job description

CareSource in Nevada seeks a Hospital Value-Based Provider Programs Manager – Markets to lead the design, implementation, and oversight of hospital value-based payment initiatives within the market. The role drives performance, quality outcomes, and provider engagement while aligning with state health plan contracts and strategic priorities.

The position requires a Bachelor’s degree and 5 years of related experience in value-based reimbursement, provider performance, or managed care operations.