VBC Performance Consultant - Population Health

CHRISTUS Health; Shreveport (LA); On-site; USD 90,000 - 130,000; Full time

Job summary

CHRISTUS Health seeks a VBC Performance Consultant to support care management teams in solving complex problems aimed at improving cost and quality on value-based contracts. This role involves monitoring trends, performing analyses of population health data, and coordinating cross-functional initiatives to achieve contract targets.

Requirements include an Associate’s degree (Bachelor’s preferred) and several years of experience in healthcare data analysis, Medicare/Medicare Advantage/Medicaid,

Qualifications

• Associate’s degree is required.
• Bachelor's degree in healthcare or related field preferred.
• Minimum 5 years of data analysis experience in Medicare, Medicare Advantage, Medicaid, and commercial payers.
• At least 3 years in healthcare and/or implementing continuous improvement methodologies.
• Experience in value-based care performance and strategy.

Responsibilities

• Monitor, analyze and synthesize trends across value-based care contract indicators to ensure network performance.
• Support cross-functional teams to achieve contract targets and program success.
• Document standard work and build processes for program sustainability.
• Act as a subject matter expert on value contracts and policy changes impacting operations.
• Lead end-to-end VBC quality performance monitoring and data submission coordination.

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