VBC Performance Consultant - Population Health

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