VBC Performance Consultant - Population Health

CHRISTUS Health; Beaumont (TX); On-site; USD 85,000 - 120,000; Full time

Job summary

CHRISTUS Health is seeking a VBC Performance Consultant to support care management teams in improving cost and quality on value-based contracts. The role involves monitoring and analyzing population health data, evaluating program performance, and guiding cross-functional initiatives to reach contract targets.

The successful candidate will interpret value contracts, communicate findings to leadership, and help develop scalable processes for program sustainability within CHRISTUS Health CIN/ACO,

Qualifications

• Associate's degree required; Bachelor's degree preferred
• Experience in data analysis within Medicare/Medicaid/Commercial programs

Responsibilities

• Monitor, analyze and synthesize trends across value-based contracts and performance indicators
• Communicate contract performance and advise on next steps to achieve metrics
• Support cross-functional teams in initiatives to achieve contract targets
• Document standard work and build processes for program sustainability
• Lead end-to-end VBC quality performance monitoring and data submission coordination

Skills

Data analysis

Medicare/Medicare Advantage

HEDIS/STARs

Population Health

Value-based care

Education

Associate's degree

Bachelor's degree in healthcare or related field

Job description

Summary

The VBC Performance Consultant is responsible for supporting the care management teams in solving complex problem focused on improving cost and quality performance on value-based contracts or alternative payment programs. This includes the CHRISTUS Health CIN/ACO, Health Plan, and other initiatives as they arise.

Responsibilities

• Meets expectations of the applicable OneCHRISTUS Competencies: Leader of Self, Leader of Others, or Leader of Leaders.
• In coordination with Manager, VBC Performance responsible for monitoring, analyzing and synthesizing trends across value-based care contract key indicators and contractual commitments to ensure network performance engaging Network and care management leadership with strategic planning to ensure success in contracts.
• Analyzing and synthesizing data (e.g., population health utilization, cost, benchmarking, quality reports) to communicate contract performance and advise on next steps required to achieve metrics to support program planning.
• Supporting the development of quantitative and qualitative evaluations and scenario modeling for contract/program participation in order to generate recommendations to leaders within and beyond Population Health Services; these evaluations will include operational feasibility, financial implications (ROI), physician impact, and general pros and cons.
• Supporting cross-functional teams in initiatives, implementation and programs to help to achieve contract targets.
• Documenting standard work for successful initiatives and building processes to ensure program sustainability.
• Analysis of relevant national programs & accreditations such as the Center for Medicare/Medicaid Services (CMS): Merit-Based Incentive Payment System (MIPS) and, National Committee for Quality Assurance, etc. for changes that may impact the organizations measures or programs.
• Serving as key point of contact to payers around value-based contracts.
• Serves as subject matter expert and interpreter of value contracts and programs to support the description of what we need to accomplish and subsequent stakeholder decisions.
• Analyze and communicate relevant policy updates in the value-based payer space, including Medicare, Medicare Advantage, commercial and Medicaid.
• Subject matter expert to advise how program and policy changes would impact CHRISTUS Health CIN day-to-day operations and performance.
• Lead work with key stakeholders to coordinate end to end VBC Quality performance monitoring/data submission coordination.
• Project manage and work with key stakeholders to support end to end implementations of key initiatives supporting care delivery.
• Identifies and participates in development of key Pop Health/ACO Education to support CHRISTUS Health employed or affiliated physician network.
• Able to think with an enterprise mindset and to continuously challenge the status quo.
• Has strong presentation skills with the ability to present to leadership.

Job Requirements

Education/Skills

• Associate's degree required
• Bachelor's degree in healthcare or related field preferred

Experience

• Associate's degree plus 5 years of experience, or bachelor's degree plus 3 years of experience working in data analysis with expertise in Medicare, Medicare Advantage, Medicaid, and commercial required
• 3 years in healthcare and/or experience in implementing continuous improvement methodologies required, with the increasing scope of complexity supporting the total cost of care reduction and HEDIS STAR rating performance required
• Experience supporting value-based care performance & strategy- improving outcomes while managing the total cost of care required
• Experience synthesizing complex information and applying good judgment to possible impacts and solutions required
• Demonstrated expertise in Medicare Advantage required
• Experience in a highly complex integrated health system or payer environment is required
• Experience in Population Health Management, such as HEDIS/STARs, CMS Quality measures, and Cost utilization programs required

Licenses, Registrations, or Certifications

• LVN/LPN or RN preferred

Work Schedule

5 Days - 8 Hours

Work Type

Full Time