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Value-Based Care and Contracting Manager
2 months ago
The Value-Based Care and Contracting Manager will be responsible for driving strategies to optimize value-based reimbursement opportunities and managing payer relationships. This position involves negotiating contracts, overseeing Accountable Care Organization (ACO) initiatives, and ensuring compliance with healthcare regulations. The role requires close collaboration with various internal teams and external stakeholders to enhance financial performance, improve patient outcomes, and maintain regulatory compliance.
Key Responsibilities:- Develop and execute strategies for value-based reimbursement, working alongside clinical and financial teams to align objectives and identify areas for improvement.
- Analyze financial and operational data to help the organization stay competitive in the evolving healthcare landscape.
- Negotiate contracts with payers, ensuring agreements are beneficial and in line with regulatory requirements.
- Oversee ACO programs, focusing on performance management, compliance, and enhancing the quality of care and patient satisfaction.
- Establish policies and procedures to ensure compliance with federal, state, and local laws related to value-based care and ACO operations.
- Conduct thorough data analyses of financial and reimbursement trends, preparing reports for senior leadership, and providing strategic insights to guide decision-making.
- Bachelor's degree in healthcare administration, business, finance, or a related field.
- Minimum of five years of experience in healthcare administration, value-based reimbursement, payer relations, or ACO management.
- Strong knowledge of value-based care models, excellent communication and negotiation skills, and the ability to balance multiple priorities in a dynamic setting.
- Problem-solving skills, familiarity with healthcare regulations, and experience working in a matrix organization.
