Manager of Performance Improvement - Value Based Care
Apply NowCompany: UHS
Location: Reno, NV 89502
Description:
Responsibilities
Prominence Health is a value-based care organization bridging the gap between affiliated health systems and independent providers, building trust and collaboration between the two. Prominence Health creates value for populations and providers to strengthen integrated partnership, advance market opportunities, and improve outcomes for our patients and members. Founded in 1993, Prominence Health started as a health maintenance organization (HMO) and was acquired by a subsidiary of Universal Health Services, Inc. (UHS) in 2014. Prominence Health serves members, physicians, and health systems across Medicare, Medicare Advantage, Accountable Care Organizations, and commercial payer partnerships. Prominence Health is committed to transforming healthcare delivery by improving health outcomes while controlling costs and enhancing the patient experience.
Learn more at: https://prominence-health.com/
Job Summary:
Under the direction of the VP of Value Based Care, the Manager of Performance Improvement - Value Based Care (VBC) is responsible for managing health plan revenue and performance of service providers under value based care agreements. This position will provide guidance and subject matter expertise to Finance and Risk Adjustment Operations in the analysis and review of risk adjustment drivers and actions needed to align with goals and forecast. The manager also collaborates with MSO providers to monitor financial performance, identify drivers, and recommend areas of opportunity. The manager works with multiple departments including analytics, finance, and compliance to ensure the correct administration, timeliness, and execution of all VBC service provider agreements and financial reconciliation. This resource provides program management support to initiatives, tactics and projects defined by executive leadership supporting risk adjustment and revenue initiatives to ensure meeting budgetary goals. The VBC manager is responsible for providing leadership in MSO and service provider management, as well as revenue initiatives, and influence multidisciplinary teams to drive actions.
About Universal Health Services:
One of the nation's largest and most respected providers of hospital and healthcare services, Universal Health Services, Inc. (UHS) has built an impressive record of achievement and performance. During the year, UHS was again recognized as one of the World's Most Admired Companies by Fortune; and listed in Forbes ranking of America's Largest Public Companies. Operating acute care hospitals, behavioral health facilities, outpatient facilities and ambulatory care access points, an insurance offering, a physician network and various related services located all over the U.S. States, Washington, D.C., Puerto Rico and the United Kingdom. www.uhs.com
Qualifications
Qualifications and Requirements:
All UHS subsidiaries are committed to providing an environment of mutual respect where equal employment opportunities are available to all applicants and teammates. UHS subsidiaries are equal opportunity employers and as such, openly support and fully commit to recruitment, selection, placement, promotion and compensation of individuals without regard to race, color, religion, age, sex (including pregnancy, gender identity, and sexual orientation), genetic information, national origin, disability status, protected veteran status or any other characteristic protected by federal, state or local laws.
We believe that diversity and inclusion among our teammates is critical to our success.
Avoid and Report Recruitment Scams
At UHS and all our subsidiaries, our Human Resources departments and recruiters are here to help prospective candidates by matching skill set and experience with the best possible career path at UHS
and our subsidiaries. During the recruitment process, no recruiter or employee will request financial or personal information (e.g., Social Security Number, credit card or bank information, etc.) from you via email. Our recruiters will not email you from a public webmail client like Hotmail, Gmail, Yahoo Mail, etc.
If you suspect a fraudulent job posting or job-related email mentioning UHS or its subsidiaries, we encourage you to report such concerns to appropriate law enforcement. We encourage you to refer to legitimate UHS and UHS subsidiary career websites to verify job opportunities and not rely on unsolicited calls from recruiters.
Prominence Health is a value-based care organization bridging the gap between affiliated health systems and independent providers, building trust and collaboration between the two. Prominence Health creates value for populations and providers to strengthen integrated partnership, advance market opportunities, and improve outcomes for our patients and members. Founded in 1993, Prominence Health started as a health maintenance organization (HMO) and was acquired by a subsidiary of Universal Health Services, Inc. (UHS) in 2014. Prominence Health serves members, physicians, and health systems across Medicare, Medicare Advantage, Accountable Care Organizations, and commercial payer partnerships. Prominence Health is committed to transforming healthcare delivery by improving health outcomes while controlling costs and enhancing the patient experience.
Learn more at: https://prominence-health.com/
Job Summary:
Under the direction of the VP of Value Based Care, the Manager of Performance Improvement - Value Based Care (VBC) is responsible for managing health plan revenue and performance of service providers under value based care agreements. This position will provide guidance and subject matter expertise to Finance and Risk Adjustment Operations in the analysis and review of risk adjustment drivers and actions needed to align with goals and forecast. The manager also collaborates with MSO providers to monitor financial performance, identify drivers, and recommend areas of opportunity. The manager works with multiple departments including analytics, finance, and compliance to ensure the correct administration, timeliness, and execution of all VBC service provider agreements and financial reconciliation. This resource provides program management support to initiatives, tactics and projects defined by executive leadership supporting risk adjustment and revenue initiatives to ensure meeting budgetary goals. The VBC manager is responsible for providing leadership in MSO and service provider management, as well as revenue initiatives, and influence multidisciplinary teams to drive actions.
About Universal Health Services:
One of the nation's largest and most respected providers of hospital and healthcare services, Universal Health Services, Inc. (UHS) has built an impressive record of achievement and performance. During the year, UHS was again recognized as one of the World's Most Admired Companies by Fortune; and listed in Forbes ranking of America's Largest Public Companies. Operating acute care hospitals, behavioral health facilities, outpatient facilities and ambulatory care access points, an insurance offering, a physician network and various related services located all over the U.S. States, Washington, D.C., Puerto Rico and the United Kingdom. www.uhs.com
Qualifications
Qualifications and Requirements:
- Bachelor's Degree in Economics, Business, Healthcare Management, or related field required; Masters degree in Healthcare Administration or related field strongly preferred
- 5-7 years of experience analyzing or managing performance of revenue and expense under financial risk. Specific expertise with Medicare or Medicare Advantage population strongly preferred.
- Minimum 3 years of proven experience in technical analysis of provider performance, health plan loss ratios, identifying and quantifying opportunities.
- 1-2 years of supervisory/managerial experience, either with direct reports or indirectly supervising others. Demonstrated experience in coaching peers and leaders on business objectives and execution.
- 3-5 years of experience with Medicare Risk Adjustment, including thorough knowledge of CMS RAF/HCC model, and experience with CMS files and datasets that enable risk-bearing organization to calculate RAF scores for each population.
- Ability to set-up, facilitate and lead performance improvement sessions with a range of business stakeholders with diverse interests.
- Experience in designing remediation plans to address efficiency issues and mitigate budget shortfalls, along with a track record of following through to ensure closure.
- Experience with payer-provider risk arrangements required. Ability to work with clinical leaders and practice administrators on drawing links between patient care and financial performance is strongly preferred.
- Experience working with value-based service providers (eg. vendors that specialize in post-acute care, kidney care, risk adjustment operations, etc.) strongly preferred. Experience in analyzing efficacy and impact of service providers is a plus.
- Strong presentation, critical thinking and problem-solving skills.
- Ability to effectively communicate in English, both verbally and in writing.
- Ability to understand, analyze and present data.
- Proficient in the use of Microsoft Office, including Project, Visio, Word, Excel, Outlook, PowerPoint and database applications. Proficiency in Microsoft Power BI is strongly preferred.
All UHS subsidiaries are committed to providing an environment of mutual respect where equal employment opportunities are available to all applicants and teammates. UHS subsidiaries are equal opportunity employers and as such, openly support and fully commit to recruitment, selection, placement, promotion and compensation of individuals without regard to race, color, religion, age, sex (including pregnancy, gender identity, and sexual orientation), genetic information, national origin, disability status, protected veteran status or any other characteristic protected by federal, state or local laws.
We believe that diversity and inclusion among our teammates is critical to our success.
Avoid and Report Recruitment Scams
At UHS and all our subsidiaries, our Human Resources departments and recruiters are here to help prospective candidates by matching skill set and experience with the best possible career path at UHS
and our subsidiaries. During the recruitment process, no recruiter or employee will request financial or personal information (e.g., Social Security Number, credit card or bank information, etc.) from you via email. Our recruiters will not email you from a public webmail client like Hotmail, Gmail, Yahoo Mail, etc.
If you suspect a fraudulent job posting or job-related email mentioning UHS or its subsidiaries, we encourage you to report such concerns to appropriate law enforcement. We encourage you to refer to legitimate UHS and UHS subsidiary career websites to verify job opportunities and not rely on unsolicited calls from recruiters.