Conduct detailed evaluations of provider practices to determine their current capabilities in value-based care and identify key areas for growth and improvement.
Obtain and analyze practice specific cost and quality data and reports for cost of care and quality opportunities.
Help practice target high risk members and gaps in care based on reports provided.
Supports practice implementation of population health management, care coordination and care management strategies.
Identify action plans for providers to implement to improve cost, quality, and the patient experience.
Participate in design, development, and implementation of community learning forums.
Serve as the point of contact for providers and primary care practices for program onboarding.
Facilitate routine meetings with the provider office.
Serve as the subject matter expert and liaison with Care Management to facilitate clinical processes between the company and the provider office.
Create and deliver tailored learning opportunities to aid providers in implementing recommended interventions effectively.
Advise executives on developing segment-specific strategies in areas such as financial performance, incentive programs, quality management, and other operational areas impacting provider success.
Requirements
Requires a BA/BS and minimum of 5 years health care experience; or any combination of education and experience, which would provide an equivalent background.
Physician environment experience in practice transformation/quality improvement
Ambulatory care setting quality and efficiency metrics
Population health and care management structures
Data analytics and electronic health records
Clinical background and/or MBA.
Proven experience in consulting within the healthcare industry.
Experience with Medicaid, Medicare, and commercial plans strongly preferred.
Strong understanding of value-based care principles and practices.
Excellent analytical skills with the ability to interpret complex data and make strategic decisions.
Experience with Salesforce or similar CRM platforms.