Value Based Care Specialist

As a Manager of Provider Solutions, your role is pivotal in guiding healthcare providers toward achieving optimal outcomes in value-based care, ultimately improving patient health and well‑being while managing costs effectively. In developing and implementing strategic initiatives to increase provider readiness from traditional fee‑for‑service models to value‑based care models, you will shape outcomes and performance.

Responsibilities

• Performance Analysis: Conduct in‑depth analysis of contractual performance metrics related to value‑based care, including utilization measures, benchmarking, cost‑effectiveness, and patient outcomes.
• Data Interpretation: Interpret and translate complex data into actionable insights for healthcare providers, helping them understand and improve their performance.
• Financial Management: Monitor financial performance related to value‑based care contracts and identify opportunities for cost savings, risk adjustment and revenue enhancement.
• Patient Engagement:
  • Develop strategies to actively involve patients in their care and treatment plans.
  • Implement patient education programs to promote health and prevent avoidable healthcare utilization.
  • Provide constructive feedback and coaching to healthcare providers, offering guidance on how to enhance their practices to align with value‑based care goals.
• Collaboration with Clinical Teams:
  • Collaborate with clinical leaders to integrate value‑based care principles into clinical practice, emphasizing preventive care, care coordination, and patient engagement.
  • Collaborate with leadership to establish goals aligned with value‑based care principles for initiatives to continuously improve care delivery, patient satisfaction, and cost‑efficiency.
• Care Coordination Optimization: Work with internal and external healthcare teams to improve care coordination efforts, ensuring seamless transitions of care and effective communication among providers.
• Technology Utilization:
  • Evaluate and recommend technology solutions that support value‑based care initiatives, including electronic health record (EHR) optimization and other relevant tools.
  • Identify and implement innovative technologies and solutions that support value‑based care delivery and improve patient outcomes.
• Educational Support: Develop and deliver training programs to educate healthcare providers and staff on best practices in value‑based care delivery.
• Risk Stratification: Assist in the development and implementation of risk stratification models to identify high‑risk patients and tailor care interventions accordingly.
• Patient Engagement Strategies: Collaborate on the development of strategies to actively engage patients in their care, promoting preventive measures and improving overall health outcomes.

Key Skills

• Analytical Skills: Proficient in analyzing healthcare data to identify patterns, trends, and areas for improvement.
• Communication Skills:
  • Effective communication skills to convey complex healthcare data and insights to diverse audiences.
  • Report on quarterly performance, internally and externally.
• Problem‑Solving: Strong problem‑solving skills to address challenges and barriers to successful value‑based care implementation.
• Interpersonal Skills: Ability to build relationships and collaborate with healthcare providers, administrators, and other stakeholders.
• Knowledge of Value‑Based Care Models: In‑depth understanding of various value‑based care models and their implications on healthcare delivery.
• Change Management:
  • Skill in managing and facilitating change within healthcare organizations.
  • Routine operational huddles will be mandated to ensure ancillary departments have ongoing intervention.
• Technology Proficiency: Familiarity with healthcare information systems and technologies supporting value‑based care.
• Educational Facilitation:
  • Ability to develop and deliver educational programs to diverse healthcare audiences.
  • Provide education and training programs for internal staff, including healthcare providers and administrative teams, to ensure a smooth transition to value‑based care.

Qualifications

• Bachelor’s degree or commensurate work experience in healthcare administration, public health, or a related field.
• 3‑5 years of experience in healthcare change management, provider relations, or a related role.
• In‑depth knowledge of healthcare regulations, value‑based care, and performance metrics.
• Strong analytical and problem‑solving skills, with the ability to interpret complex data sets and identify improvement opportunities.
• Excellent communication and interpersonal skills to collaborate effectively with providers, team members, and stakeholders at all levels.
• Proven experience in designing and delivering training programs or educational initiatives.
• Proficiency in data management and analysis tools, such as Excel or data visualization software.
• Familiarity with electronic health record systems and healthcare information technology.
• Detail‑oriented, organized, and able to manage multiple projects simultaneously.
• Ability to work independently, demonstrate initiative, and drive results in a fast‑paced environment.
• Position is remote – secure home network required and familiar with Microsoft Office products and VPN.

Preferred

• Six Sigma Green Belt, Licensed Allied Health Professional, or Licensed Registered Nurse.
• Certified Professional in Healthcare Quality (CPHQ) or equivalent.

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