CHESS: Manager, Value Based Contract Operations (Hybrid)

Manager of Value Based Contracts Position Summary : The Manager of Value Based Contracts will be responsible for assisting the Director of Value Based Contracting to ensure the profitability of contracts for CHESS and CHESS clients.

This will include, but not limited to, the implementation, operations and maintenance of existing managed care contracts and payer relationships for all CHESS value-based contracts.

The activities are ultimately to lead to the success of CHESS value-based contracts. Position Responsibilities :

• Manages contract implementation and education of current and potential value-based contracts for the internal CHESS team and CHESS clients regarding contract parameters.
• Optimize quality, shared savings and risk payments of value-based contracts by advising, consulting, and collaborating with internal and CHESS client clinical teams to optimize clinical operations of teams, processes, and technology.
• Work directly with payer partners to request additional reporting to execute on opportunities and understand cost trending, RAF changes, quality performance.
• Analyzes, disseminates, educates, and operationalizes value reporting and data analytics (claims, clinical and financial data) to internal CHESS teams and CHESS client organizations to identify trends to engage value stakeholders around opportunities and strategies to improve the quality of care and lower the cost of care.
• Facilitates Business and Operational meetings with payer partners and with internal and external stakeholders to review contract performance on a monthly, quarterly, or as needed basis.
• Work with Finance department to coordinate and validate value-based contract payments and performance reports.
• Assists in developing creative solutions to enhance attribution and contract performance.
• Responds to client inquires and resolves concerns.
• Reviews and implements managed care policies and procedures.
• Communicate effectively, efficiently, and courteously, demonstrating excellent verbal and written communication skills as well as preparing and delivering presentations, with colleagues at every level within the organization and with CHESS clients.
• Assists the Director of Value Based Contracting with other value-based contract initiatives as directed.
• You may be required to travel up to 10%.
• Other duties as assigned.

Please note this job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee for this job.

Duties, responsibilities, and activities may change at any time with or without notice.

Position Qualifications :

Required

• Bachelor’s Degree (BA / BS) in related field preferred.
• Strong analytic skills, and the ability to trend data and prepare presentations
• Minimum of 3 years of experience in managed care.

Preferred

• Master’s degree in health or business administration
• Project Management experience

Skills, Knowledge, and Abilities

• Knowledge of medical terminology.
• Knowledge of organizational policies, procedures, and protocols.
• Excellent oral and written communication skills
• Exceptional customer service, and interpersonal skills
• Effective problem-solving and influencing skills.
• Strong organizational, self-motivation, and decision-making skills
• Proficiency using Microsoft programs (Word, Excel, PowerPoint)
• Ability to work independently and collaboratively, as needed.

Key Competencies :

• Be a team player by supporting decisions, embracing change, managing conflict effectively, and valuing the contributions of others.
• Cooperate and support co-workers to create client collaboration towards Value-Based healthcare.
• Take all measures to protect the privacy of clients, patients, employees, and guests.

MedCost provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws.

This policy applies to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absence, compensation and training.

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