Senior Clinical Professional - Value-Based Care
New Today
Improving Healthcare Outcomes
You could be the one who changes everything as a clinical professional on our Medical Management/Health Services team. At our organization, we offer competitive benefits and a fresh perspective on workplace flexibility.
Position Purpose: Value-based care is a key strategy in improving outcomes, advancing quality, and promoting equity. As an Analyst, Value-Based Payment Initiatives (VBP), you will support the expansion and performance of Medicare-focused VBP arrangements across New York, including Medicare Advantage and Dual Eligible Special Needs Plans (D-SNPs). This position requires effective collaboration with Contract management and Service Fund teams to implement monitoring of Medicare-specific VBP contracts.
Partner with Contract management and Service Fund teams to monitor Medicare-specific VBP contracts and ensure alignment with organizational objectives.
Analyze provider performance against contract benchmarks and prepare routine reporting for internal and external stakeholders.
Identify trends and performance drivers to support provider outreach efforts and inform opportunities for improvement or innovation in VBP strategies.
Assist in building and refining Medicare contract models, incorporating CMS and NYSDOH guidelines.
Collaborate with internal teams to align on incentive structures, attribution methodologies, and provider engagement needs.
Track changes in CMS policy, Stars metrics, and VBP guidance to ensure analytical work and contract support align with current requirements.
Prepare analyses, data visualizations, and summaries to support contract negotiations, governance discussions, and strategic planning.
Main Responsibilities:
Develop health-related social needs strategies aimed at addressing non-medical factors that influence health outcomes and equity.
Recommend reporting enhancements based on VBP partner feedback and needs identified through regular use of reporting tools.
Special projects as assigned or directed.
Requirements:
BA/BS – Bachelors Degree Required. MBA/MHA/MPH Preferred.
Graduate education in health care administration or other related areas preferred.
Minimum of 1-3 years of relevant healthcare operation or policy experience.
Ability to communicate with internal and external business partners effectively.
Strong written and oral communication skills.
Knowledge of population health management, medical expense and quality performance analysis preferred.
Benefits and Opportunities:
We offer a dynamic work environment with opportunities for growth and development.
A comprehensive benefits package, including competitive salary, health insurance, and retirement savings plan.
Professional development opportunities, including training, mentorship, and networking events.
- Location:
- East Providence, United States