Manager, Population Health Business Performance

Sentara
life insurance, vision insurance, parental leave, paid time off, sick time
United States, Virginia, Virginia Beach
Nov 10, 2024
City/State Virginia Beach, VA Overview Work Shift First (Days) (United States of America) Manager, Population Health Business Performance Position Status: Full-time, Day Shift Location: This is an on site position located at 1300 Sentara Park, Norfolk, VA Standard Working Hours: 8:00AM to 5:00PM (ET). Position Summary: Manager, Population Health Business Performance leads Population Health Team projects, activities, and initiatives that directly support the mission and objectives of the Population Health division of Sentara Health. Under the direction of the Vice President of Population Health, this role is responsible for : identifying, designing, and implementing Key Performance Indicator tracking mechanisms, models, and other services that will best meet Sentara Health's needs for growth in SACO and SQCN. Responsible for leadership and oversight of effective contract performance management and financial performance related to Value Based Care Contracts with Federal (CMS) and Commercial (ex. Humana, Aetna) payers; creating, and delivering solutions that are scalable and create a repeatable success for SQCN and SACO. Works In close coordination with the acute care, health plan, physician leaders, and key stakeholders to translate high-level organizational strategies into actionable and scalable performance measurement, facilitate/drive delivery of strategy, designs, prototypes and pilots. Provides thought leadership to the organization regarding the evolving opportunities - including but not limited to operational efficiencies, new CMMI opportunities, new markets, predictive analytics, population management, clinical decision support, care pathway automation. Maintains a portfolio management process for all innovation initiatives, prioritize initiatives and drive delivery for high priority/all initiatives. Collaborates with managed care, finance, analytics and reporting to evaluate programs effectiveness and ROI Minimum Requirements: Bachelor's Level Degree (Business Administration, Finance or Healthcare Management/Admin) 5-10 years experience in the following: CMS and or CMMI Regulatory Environment Contract Management Outcomes Management Program Management Project Management Diversity and Inclusion at Sentara Our vision is that everyone brings the strengths that come with diversity to work with them every day. When we are achieving our vision, we have team members that feel they belong and can be their authentic selves, and our workforce is reflective of the communities we serve. We are realizing this vision through our Diversity and Inclusion strategy, which has three pillars: A diverse and talented workforce, an inclusive and supportive workplace, and outreach and engagement with our community. We have made remarkable strides in these areas over the past several years and, as our world continues to evolve, we know our work is never done. Our strategies focus on bothstructural inclusion, which looks at our organizational structures, processes, and practices; as well asbehavioral inclusion, which evaluates our mindsets, skillsets, and relationships. Together, these strategies are moving our organization forward in an environment that fosters a culture of mutual respect and belonging for all. Please visit the link below to learn more about Sentara's commitment to diversity and inclusion: https://www.sentara.com/aboutus/mission-vision-and-values/diversity.aspx SentaraOverview For more than a decade, Modern Healthcare magazine has ranked Sentara Health as one of the nation's top integrated healthcare systems. That's because we are dedicated to growth, innovation, and patient safety at more than 300 sites of care in Virginia and northeastern North Carolina, including 12 acute care hospitals. Sentara Benefits As the third-largest employer in Virginia, Sentara Health was named by Forbes Magazine as one of America's best large employers. We offer a variety of amenities to our employees, including, but not limited to: Medical, Dental, and Vision Insurance Paid Annual Leave, Sick Leave Flexible Spending Accounts Retirement funds with matching contribution Supplemental insurance policies, including legal, Life Insurance and AD&D among others Work Perks program including discounted movie and theme park tickets among other great deals Opportunities for further advancement within our organization Sentara employees strive to make our communities healthier places to live. We're setting the standard for medical excellence within avibrant, creative, and highly productive workplace. For information about our employee benefits, please visit:Benefits - Sentara (sentaracareers.com) Join our team!We are committed to quality healthcare, improving health every day, and provide the opportunity for training, development, and growth! Please Note:The yearly Flu Vaccination is required for employment. *Note:* Sentara Health offers employees comprehensive health care and retirement benefits designed with you and your family's well-beingin mind. Ourbenefits packages are designed to change with you by meeting yourneeds now and anticipating what comes next. You have a variety of options for medical, dental and vision insurance, life insurance, disability, and voluntary benefits as well as Paid Time Off in the form of sick time, vacation time and paid parental leave. Team Members have the opportunity to earn an annual flat amount Bonus payment if established system and employee eligibility criteria is met. Manager Population Health Analytics Norfolk Virginia Program Process Management Job Summary This role is a part of the population health leadership team and is responsible for leadership and oversight of effective financial analytics and operational performance related to Value Based Care Contracts with Federal (CMS) and Commercial (ex. Humana, Aetna) payers. Acts as the financial analytical lead to ensure that all state, federal, and payer contracts are analyzed for risk and opportunity and key performance indicators are implemented timely and correctly. Establishes workgroups and works closely with the operational areas to inform them of financial performance and impact within the ongoing performance analysis. Provides functional and technical support regarding variance from Key Performance Indicators. Develops Key Performance Indicators and breakdowns of each of our contracts including vendor contracts and implementations. This leader will work with analytics and reporting teams to develop metrics for efficiency and performance of all contracts and implementations. Develops and implements plans to identify root causes and actions necessary to resolve performance variances. Facilitates development of various reporting tools to monitor operational functions and identify opportunities for improved performance, including development and analysis of reports. Fosters partnerships and develops relationships with key stakeholders internal and external to Sentara. Being Well versed in physician reimbursement models to be able to articulate the value of fee for value reimbursement models. Subject Matter Expertise in MSSP and other CIN models Regulatory and compliance knowledge of CIN safe harbors and MSSP. Development, tracking, and reporting of Key Performance Indicators across Population Health in Sentara. Financial Performance Analysis within all SQCN and SACO Contracts. Collaborates with Managed Care for contract analysis prior to signature maintains measurement of identified metrics post contract. Develops and operates financial distribution methodologies and management of those distributions. Develops incentive structures to support value-based care. Collaborates with Manager of Operations for Operational performance measurement. Collaborates with reporting and analytics to tie quality and utilization performance with financial projections and outcomes. Must comply with all HIPAA rules and regulations. Must provide reliable transportation. Qualifications: BLD - Bachelor's Level Degree: Business Administration/Management (Required), BLD - Bachelor's Level Degree: Finance (Required), BLD - Bachelor's Level Degree: Healthcare Management/Administration (Required), BLD - Bachelor's Level Degree (Required) CMS, CMMI Regulatory Environment, Contract Management, Outcomes Management, Program Management, Project Management Skills Sentara Healthcare prides itself on the diversity and inclusiveness of its close to an almost 30,000-member workforce. Diversity, inclusion, and belonging is a guiding principle of the organization to ensure its workforce reflects the communities it serves. Per Clinical Laboratory Improvement Amendments (CLIA), some clinical environments require proof of education; these regulations are posted at ecfr.gov for further information. In an effort to expedite this verification requirement, we encourage you to upload your diploma or transcript at time of application. In support of our mission "to improve health every day," this is a tobacco-free environment.