Value-Based Reimbursement Program Lead

CareSource; Kentucky; On-site; USD 83,000 - 133,000; Full time

Job summary

CareSource in Kentucky is seeking a Value Based Reimbursement Program Manager to oversee VBR programs across markets and lines of business, including risk-sharing arrangements, ACOs, STARs Pay For Quality, and episodic care models.

You will partner with Finance, Medical Economics, and network teams to develop governance, dashboards, and performance initiatives, while coordinating with providers to optimize outcomes and contract value.

Qualifications

• Bachelor’s degree in business administration, or related field or equivalent work experience is required.
• Minimum of five years of experience in value-based reimbursement design, methodologies and/or VBR contracting, data analysis, reporting, or data support is required.
• Provider contracting or provider relations experience preferred.

Responsibilities

• Assist in evaluating opportunities and use data to inform VBR program value.
• Coordinate real-time reporting and dashboards for financial, quality, and clinical performance.
• Develop VBR governance for contract tracking and approvals.
• Improve performance with Finance and Medical Economics teams and build predictive models.
• Engage national/market network teams and providers to improve results.
• Develop enterprise protocols to align market and enterprise functions.
• Identify and implement performance improvement initiatives with new contracts.
• Oversee population management initiatives and coordinate with cross-functional groups.
• Manage multiple projects and disseminate data to appropriate departments.

Skills

Microsoft Office

Written communication

Analytical skills

Problem solving

Interpersonal skills

Collaboration

Critical thinking

Education

Bachelor's degree in business administration or related field

Job description

CareSource in Kentucky is seeking a Value Based Reimbursement Program Manager to oversee VBR programs across markets and lines of business, including risk-sharing arrangements, ACOs, STARs Pay For Quality, and episodic care models.

You will partner with Finance, Medical Economics, and network teams to develop governance, dashboards, and performance initiatives, while coordinating with providers to optimize outcomes and contract value.