Overview
The Bundle Payment Program Manager plays a crucial role in managing and overseeing alternate payment models (bundled payment, capitation, pay for performance, etc.
within our clinically integrated network and accountable care organization. This position requires a deep understanding of value-based care models, healthcare reimbursement, and clinical integration principles.
Responsibilities
Program Oversight : Lead the development, implementation, and ongoing management of payment bundle programs across various specialties and service lines within the healthcare network.
Responsible for creating all presentations and assisting in all formal committee and key stakeholder leader directives.
Contract Management : Collaborate with internal stakeholders and external partners to negotiate and manage value-based risk contracts related to payment bundles.
Ensure compliance with contract terms and regulatory requirements.
Financial Analysis : Conduct financial analysis and forecasting related to payment bundle programs. Monitor program performance and identify opportunities for improvement in cost efficiency and quality outcomes.
Work with finance for all payments to be distributed to Physicians and ensuring all fair market value analysis and planning is done in advance with any employed groups.
Provider Engagement : Facilitate communication and collaboration with healthcare providers participating in payment bundle programs.
Provide education and support to ensure alignment with program goals and objectives. Support the Physician Alternative Payment Committee.
Data Management : Work closely with data analysts and IT teams to collect, analyze, and report on relevant healthcare data related to payment bundle programs.
Utilize data insights to drive program optimization and decision-making.
Quality Improvement : Implement strategies to enhance the quality of care delivered within payment bundle programs. Assist in identifying, managing and monitor key quality indicators and implement interventions to address areas for improvement.
Regulatory Compliance : Stay informed about changes in healthcare regulations and payment policies related to value-based care and payment bundling.
Ensure program compliance with all regulatory requirements.
Cross-Functional Collaboration : Collaborate with other departments, including finance, operations, quality assurance, and clinical leadership, to achieve program objectives and ensure seamless integration with other organizational initiatives.
Communications and Physician Relations : Excellent at communicating (written and oral) with Physicians and Key stakeholder leaders.
Qualifications
EDUCATION :
Required : Bachelor's Degree
Bachelor's degree in healthcare administration, business, finance, accounting, or related field. Preferrred Master's degree.
EXPERIENCE : Required : 3 years
Minimum of 3 years of experience in healthcare administration, with a focus on value-based care, payment reform, or population health management.
LICENSURE / CERTIFICATION / REGISTRY / LISTING :
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