Value Based Care Consultant Sr. fostering long-term partnerships to drive enhanced patient outcomes in health care. Consulting with providers to achieve value-based care across Medicare, Medicaid, and Commercial lines.
Responsibilities
Conduct detailed evaluations of provider practices to determine current capabilities in value-based care and identify key areas for growth and improvement.
Engage in a continuous process that includes assessment, root cause analysis, strategy development, implementation, and outcomes tracking for each provider.
Assist providers with executing action plans focused on population health management, patient satisfaction, and optimizing quality and cost performance.
Lead collaborative meetings with provider staff and internal stakeholders to ensure alignment and successful deployment of strategic initiatives.
Create and deliver tailored learning opportunities to aid providers in implementing recommended interventions effectively.
Educate providers on using proprietary tools, data, and technology to improve performance in critical metrics, driving effective and efficient care.
Utilize data analytics to continuously monitor and track key performance metrics for assigned providers, ensuring data-driven decision-making.
Accurately document all action plans, interventions, and provider activities in Salesforce to maintain comprehensive records and reporting capabilities.
Cultivate and maintain strong, long-term relationships with physicians, providers, and healthcare systems to support financial and quality improvements within the health plan contract.
Advise executives on developing segment-specific strategies in areas such as financial performance, incentive programs, quality management, and other operational areas impacting provider success.
Exercise independent judgment on complex issues, working under minimal supervision to evaluate variable factors and determine optimal courses of action.
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.
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 is preferred.
Benefits
comprehensive benefits package
incentive and recognition programs
equity stock purchase
401k contribution
Job title
Senior Value Based Care Consultant – Ohio Provider Success
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