Job SummaryUnder general supervision develops, coordinates, and implements operational components of pay-for-performance and quality programs under various health plan and employer agreements. Works closely with providers to ensure effective participation in and adherence to payer defined requirements. Continually evaluates, communicates and implements measures aimed at meeting the program requirements.Essential Functions
Manages assigned projects and initiatives including; health plan/payer reporting needs, develops project plans, and implements steps needed to achieve goals and timelines for pay-for-performance and quality initiatives; assesses current state, analyzes practice and gains support for required changes.
Provides support for Corewell Health network providers to maintain compliance in all value-based health plan quality program requirements. Stays abreast of program changes and implements them as needed.
Establishes and maintains strong partnerships with Corewell Health ACO physicians, provider office staff, and other key stakeholders to ensure timely and accurate communication of program requirements and updates.
Collaborates with ACO team, Medical Directors, and operational leaders to ensure the development and implementation of strategies for success related quality and process improvement, utilization, and cost.
Manages multiple ambulatory practices in implementing action plans, monitor and evaluates progress as needed to achieve targets for programs.
Assist with the on-going data collection (including audits), data entry, and data evaluation.
Responsible for training staff regarding HEDIS measures, quality improvements principles and standards, conducting PDSA, Cycle Time analysis, Process Mapping, Gap analysis, and facilitate quality improvement.
Works with ACO data staff to develop reporting procedures that will guide the management of processes and to improve compliance with specified metrics needed to meet program goals.
Travel to other office/practice sites and meeting and training locations.
QualificationsRequired
Bachelor's Degree or equivalent in business or healthcare related field.
3 years of relevant experience administrative healthcare or health care management experience.
How Corewell Health cares for you
Comprehensive benefits package to meet your financial, health, and work/life balance goals. Learn more here (https://careers.corewellhealth.org/us/en/benefits-new) .
On-demand pay program powered by Payactiv
Discounts directory with deals on the things that matter to you, like restaurants, phone plans, spas, and more!
Optional identity theft protection, home and auto insurance, pet insurance
Traditional and Roth retirement options with service contribution and match savings
Primary LocationSITE - Beaumont Service Center - 26901 Beaumont BlvdDepartment NameAccountable Care OrganizationEmployment TypeFull timeShiftDay (United States of America)Weekly Scheduled Hours40Hours of WorkVariableDays WorkedMonday to FridayWeekend FrequencyN/ACURRENT COREWELL HEALTH TEAM MEMBERS – Please apply through Find Jobs from your Workday team member account. This career site is for Non-Corewell Health team members only. Corewell Health is committed to providing a safe environment for our team members, patients, visitors, and community. We require a drug-free workplace and require team members to comply with the MMR, Varicella, Tdap, and Influenza vaccine requirement if in an on-site or hybrid workplace category. We are committed to supporting prospective team members who require reasonable accommodations to participate in the job application process, to perform the essential functions of a job, or to enjoy equal benefits and privileges of employment due to a disability, pregnancy, or sincerely held religious belief.Corewell Health grants equal employment opportunity to all qualified persons without regard to race, color, national origin, sex, disability, age, religion, genetic information, marital status, height, weight, gender, pregnancy, sexual orientation, gender identity or expression, veteran status, or any other legally protected category.An interconnected, collaborative culture where all are encouraged to bring their whole selves to work, is vital to the health of our organization. As a health system, we advocate for equity as we care for our patients, our communities, and each other. From workshops that develop cultural intelligence, to our inclusion resource groups for people to find community and empowerment at work, we are dedicated to ongoing resources that advance our values of diversity, equity, and inclusion in all that we do. We invite those that share in our commitment to join our team.You may request assistance in completing the application process by calling 616.486.7447.