Plus Care Network Program Specialist

HCA Healthcare; Nashville (TN); On-site; USD 70,000 - 95,000; Full time

Job summary

HCA Healthcare seeks a Plus Care Network Program Specialist to oversee development, contracting, and performance improvement for PCNs and VBEs. You will act as SME for AKS Safe Harbors, ensure compliance, and manage contract-related documentation and data analytics.

The role involves coordinating with Legal, Compliance, and field operations, promoting network optimization, and educating stakeholders on program deliverables and requirements. Up to 25% travel may be required.

Qualifications

• Must manage multiple projects simultaneously and deliver high-quality services.
• Healthcare-related experience, such as hospital, post-acute, physician or value-based care operations.
• 2 years of experience executing strategies and building relationships to achieve performance metrics.

Responsibilities

• Audit VBE compliance with stated purpose.
• Coordinate and manage the contract lifecycle for PCN participants.
• Develop programs to enhance and grow post-acute networks.
• Liaise with Legal, Compliance and Operations to ensure alignment with policies.

Skills

Effective communication

Data manipulation in Excel

Data integrity

Organizational skills

Problem solving

Conflict management

Negotiation

Decision making

Education

Undergraduate degree required

Preferred study: business management with ethics/compliance/law/project management

Tools

Microsoft Excel

PowerPoint

Job description

Are you passionate about the patient experience? At HCA Healthcare, we are committed to caring for patients with purpose and integrity. We care like family! Jump-start your career as a Plus Care Network Program Specialist today with HCA Healthcare.

Job Summary And Qualifications

The Plus Care Network Program Specialist will oversee the development, contracting, execution, and ongoing performance improvement efforts of our post-acute care networks, called Plus Care Networks.

This position serves as a subject matter expert for the Value-Based Enterprises (VBEs) established to ensure our Plus Care Networks comply with Value-Based Arrangement Safe Harbors under the Anti-Kickback statutes (AKS); specifically, Safe Harbors protecting the “Care Coordination Arrangements to Improve Quality, Health Outcomes and Efficiency.”

This position serves as the primary support contact for the contractual agreements that exist between owned and independent post-acute care providers participating and one of 25 VBEs. As the point of contact, this position will be responsible for:

• Auditing each VBE compliance with its stated purpose.
• Ensuring each VBE governing structure and deliverables are met and documented.
• Ensuring each VBE is prepared for external audits or compliance reviews.

Finally, this position will liaise with various corporate departments and leaders regarding our VBEs and post-acute network strategies to ensure initiatives are delivering value to the enterprise and are aligned with related company policies, goals, and objectives.

Duties include but are not limited to:

• Manage the process of evaluating, selecting, and contracting with post-acute providers to participate in HCA Healthcare’s Plus Care Networks (PCN).
• Develop programs to enhance and grow post-acute networks, including the development of preferred provider network selection criteria and optimization of network performance.
• Support Plus Care Network operations; initiatives, collateral, audits, and compliance, through regular coordination with field based operators and leadership to ensure consistency across Divisions and hospitals.
• Coordinate and communicate the entire contract lifecycle, from pre-award to post-execution, for Plus Care Network (PCN) participants. This will include cross-functional coordination including HCA Legal, PCN operations and facility operations/leadership.
• Maintains an accurate listing of PCN contracting relationships and affiliated post-acute provider information to support accurate data analytics.
• Responsible for maintaining all PCN related collateral, including flyers, websites, and educational material.
• Serve as the department's subject matter expert on its Value-Based Enterprises, established to support the Plus Care Networks objectives. Ensures all compliance requirements and documentation are in good standing.
• Provide education to internal and external stakeholders on PCN and VBE program deliverables and compliance requirements.
• Represent the corporate Bundled Payments Department as requested with HCA Legal, Compliance, and Internal Audit to ensure programs are administered in accordance with all internal and external regulations audit requirements.
• Ensure all PCN related compliance documentation is saved and organized in accordance with document retention guidelines.
• Liaison with key stakeholders for all issues related to the development, execution, and ongoing management of PCNs and VBEs. Must possess a strong attention to detail to ensure all compliance requirements are met.
• Promote effective teamwork.
• Communicate and escalate unresolved issues at the appropriate time and to the appropriate level of management.

Competencies:

Knowledge:

• Proficient in Microsoft Excel and PowerPoint
• Knowledge of acute and post-acute clinical and care coordination acumen and strategies
• Knowledge of Value-Based Care models and terminology
• Knowledge of Value-Based Enterprise regulatory compliance requirements.

Skills:

• Effective communication skills, oral, written, and presentation
• Must be able to manipulate data in Excel and ensure the integrity of reports
• Strong Organizational skills
• Problem-solving skills
• Conflict Management
• Negotiation skills
• Decision-making skills

Abilities:

• Strong planning and multi-tasking abilities
• Ability to translate ideas into action
• Ability to think strategically
• Ability to work independently to achieve goals
• Must have initiative and excellent follow-through
• Ability to influence peers

Requirements:

• Candidate must communicate clearly and concisely both verbally and in writing. Must be able to manage multiple projects simultaneously. Must be effective in managing and leading others toward desired outcomes, setting high-performance standards, and delivering high-quality services.
• 2 years experience, with demonstrated success in executing strategies, building positive relationships, and optimizing data and analytics to achieve desired performance metrics.
• Must have healthcare-related experience, such as hospital, post-acute, physician or value-based care operations.
• Education: Preferred areas of study include business management, with concentrations in ethics and compliance, law, or project management.
• Undergraduate degree required
• The job may require up to 25% travel

Benefits

HCA Healthcare, offers a total rewards package that supports the health, life, career and retirement of our colleagues. The available plans and programs include:

• Comprehensive benefits for medical, prescription drug, dental, vision, behavioral health and telemedicine services
• Wellbeing support, including free counseling and referral services
• Time away from work programs for paid time off, paid family leave, long- and short-term disability coverage and leaves of absence
• Savings and retirement resources, including a 401(k) Plan with a 100% match on 3% to 9% of pay (based on years of service), Employee Stock Purchase Plan, flexible spending accounts, preferred banking partnerships, retirement readiness tools, rollover support and financial wellbeing counseling
• Education support through tuition assistance, student loan assistance, certification support, dependent scholarships and a partnership with Galen College of Nursing
• Additional benefits for fertility and family building, adoption assistance, life insurance, supplemental health protection plans, auto and home insurance, legal counseling, identity theft protection and consumer discounts

Learn More About Employee Benefits

Note: Eligibility for benefits may vary by location.

HCA Healthcare (Corporate)

Based in Nashville, Tennessee, supports a variety of corporate roles from business operations to administrative positions. Like our colleagues in any HCA Healthcare hospital, our corporate campus employees enjoy unparalleled resources and opportunities to reach their potential as healthcare leaders and innovators. From market rate compensation to continuing education and career advancement opportunities, every person has a solid foundation for success. Nashville is also home to our Executive Development Program, where exceptional employees are groomed to take on CNO- and COO-level roles in our hospitals. This selective program focuses on ethics, leadership and the financial and clinical knowledge required of professionals at this level of the industry.

HCA Healthcare has been recognized as one of the World's Most Ethical Companies® by the Ethisphere Institute more than ten times. In recent years, HCA Healthcare spent an estimated $3.7 billion in cost for the delivery of charitable care, uninsured discounts, and other uncompensated expenses.

“The great hospitals will always put the patient and the patient's family first, and the really great institutions will provide care with warmth, compassion, and dignity for the individual.”- Dr. Thomas Frist, Sr.

HCA Healthcare Co-Founder

We are an equal opportunity employer. We do not discriminate on the basis of race, religion, color, national origin, gender, sexual orientation, age, marital status, veteran status, or disability status.