Value-Based Purchasing Lead

CenterWell Value-Based Purchasing Lead - Denver, Colorado

Become a part of our caring community and help us put health first

Please read the following job description thoroughly to ensure you are the right fit for this role before applying.

The Value Based Purchasing Lead will be responsible for implementing clinical quality programs to drive Total Performance Score in Quality Reporting Programs.

The Value Based Purchasing Lead will be accountable for educating clinical teams on new regulations and metrics as well as related standards and best practices.

The Value Based Purchasing Lead will interface with the clinical quality team to design interventions with VBP in mind.

Strategic management of integration of CMS Home Health Value-Based Purchasing Model into CenterWell Home Health.

Responsible for collating data to be reported as part of the Home Health Quality Reporting Program (QRP) including ongoing monitoring of supporting claims based, HHCAHPS, and OASIS metrics.

Regularly monitors regulatory updates impacting VBP including but not limited to changes in measures for Total Performance Scores, updates to reimbursement via HHRG and PDGM, updates to COPs, etc.

Use your skills to make an impact

Required Qualifications

• Clinical licensure : Nursing & Therapy
• Home health quality management experience
• 2 or more years of project leadership experience
• Advanced Microsoft Excel skills including ability to link pivots to external data sources, creating pivot tables and summarizing data into reports and dashboards
• Proficiency in verbal and written communication to senior and executive leadership
• Strong organizational skills and ability to manage multiple or competing priorities
• Strong analytical and problem solving skills
• Must be passionate about contributing to an organization focused on continuously improving consumer experiences
• Plan proactively for implementation of new metrics along with regular monitoring including setting up appropriate workflows.
• Calibrates communication and details to appropriate stakeholder group, elevating business outcomes to senior leaders and tactical implementation plans to clinical working teams.
• Commitment to and execution of quality improvement programs.
• Deep understanding of CMS VBP model
• Ability to navigate CMS model compliance and manage external and internal cross-functional relationships.
• Ability to analyze clinical data to identify key drivers of value per CMS VBP model.

Scheduled Weekly Hours : 40

Pay Range : The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting.

The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc.

$102,200 - $140,700 per year. This job is eligible for a bonus incentive plan based upon company and / or individual performance.

Description of Benefits : Humana, Inc. and its affiliated subsidiaries (collectively, 'Humana') offers competitive benefits that support whole-person well-being.

Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work.

Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities.

About us : CenterWell Home Health specializes in personalized, comprehensive home care for patients managing a chronic condition or recovering from injury, illness, surgery or hospitalization.

Our care teams include nurses, physical therapists, occupational therapists, speech-language pathologists, home health aides, and medical social workers - all working together to help patients rehabilitate, recover and regain their independence so they can live healthier and happier lives.

CenterWell creates experiences that put patients at the center. As the nation's largest provider of senior-focused primary care, one of the largest providers of home health services, and fourth largest pharmacy benefit manager, CenterWell is focused on whole-person health by addressing the physical, emotional and social wellness of our patients.

As part of Humana Inc. (NYSE : HUM), CenterWell offers stability, industry-leading benefits, and opportunities to grow yourself and your career.

Equal Opportunity Employer : It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or veteran status.

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