Posted in Other 30+ days ago.
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Type: Full Time
Location: Edison, New Jersey
MANAGER PAYER VALUE BASED SOLUTION
CORP MANAGED CARE ADMIN
Temporary without Benefits
Standard Hours Per Week
8:30 a.m. - 5:00 p.m.
No Weekends Required
On Call Work
No On-Call Required
Under the direction of the Vice President, Commercial Markets & Value Based Care, this position is responsible for managing strategic objectives of the Hackensack Meridian Health Partners (HMHP) Clinically Integrated Network and Hackensack-Meridian pay-for-performance programs. This position serves as a liaison to contracted plans on behalf of: Population Health leadership, medical management teams, IT, participating physicians, and Financial Analytics. Additional responsibilities include: overseeing existing and new pay-for-performance (P4P) programs, development and monitoring end-to-end program processes, contract program implementation, measurement and dissemination of program performance, and related project tasks.
Responsible for relationship management, and day-to-day interaction with internal and external business partners.
Works collaboratively with cross functional teams in support of improved patient care coordination, quality metrics and health outcomes.
Ensures that administrative procedures are followed and financial incentive payments are distributed consistent with HMHP protocols and Board directives.
Oversees the operational and financial performance of Network strategic objectives and goals.
Analytical Reporting of HMHP/P4P with Population Health Team and Finance
Coordinate existing and new HMHP P4P programs with Hackensack Meridian Health teams. Responsible for tracking: HMHP value based contract performance and reimbursement, member attribution, care coordination payments, total cost of care baselines and performance, ambulatory HEDIS quality reports. Ensure necessary updates are made to budget/shared savings and associated value based tracking processes.
Short and Long-term Strategies
Develops short and long term strategies around HMHP/P4P program design development and direction; evaluate new program design, tracking metrics, and reimbursement strategies with cross-functional team support of Population Health medical teams, IT and Financial Analytics.
Internal and External Presentations
Develops presentation materials and analytic reports to assist Network Coordinators, Population Health leadership, physician membership, clinical teams.
Other duties as directed by Vice President, Commercial Markets and Value Based Care.
Bachelor Degree - Required
3+ years Value Based Operations and Implementation Experience - Required
3+ years Analytical Experience - Required
Meridian Health is committed to the principles of equal employment opportunity and affirmative action and will not discriminate in the recruitment or employment practices on the basis of race, color, creed, national origin, ancestry, marital status, gender, age, religion, sexual orientation, gender identity/expression, disability, veteran status and any other category protected by federal or state law.