Sr Provider Performance Mgr
1 month ago
Job Summary:
The Senior Provider Performance Manager (PPM) at Community Health Choice serves as the lead in establishing and supporting a collaborative, innovation-focused relationship with participating practice groups. The primary goal of this role is to optimize practice performance in a value based and/or risk-based environment and assess it against industry standards. The PPM will collaborate internally with various departments, including Credentialling, Medical Affairs, and Technology Platform. Externally, they will work with payer representatives and community partners.
In addition, the Sr. Provider Performance Manager (PPM) at Community Health Choice serves as the team lead for the Provider Performance team. They will be assigned a group of territories to assist with training, mentor new staff members and ensure consistent messaging to the provider network.
JOB SPECIFICATIONS AND CORE COMPETENCIE
Reponsibilities:
Lead and Manage Provider Group PracticesMaximize Population Health Outcomes and Provider SatisfactionDrive Practice Improvement and TransformationRelationship Building and CollaborationData Analysis and ReportingReports to Position Title: Director, Provider Performance
QUALIFICATIONS: Required
Education/Specialized Training/Licensure:Bachelor's degree in business, healthcare administration, or a related field of study;
Or 8 years’ experience in lieu of degree (Must be the equivalent combination of required education and minimum experience.)
Work Experience (Years and Area):Minimum of three (4) years of experience in the healthcare industry, preferably with healthcare network operations and/or practice management with degree.
Minimum of seven (8) years of experience in the healthcare industry, preferably with healthcare network operations and/or practice management without Bachelor’s degree.
Software Proficiencies: Proficiency with Microsoft Office applications and web-based technologies
Other:
Demonstrated understanding of risk and value-based contracting.Strong provider relations skills and experience.Familiarity with payment alternatives such as fee for service, capitation, global budget, performance compensation and episode of care payment.Knowledge of patient and practice risk adjustment mechanics and premium-based payment methodologies.Demonstrated ability to gain acceptance and compliance from providers and staff to achieve a mutually beneficial outcome.Excellent problem solving skills, including the ability to systematically analyze problems, draw relevant conclusions and devise appropriate courses of action.Ability to convey complex or technical information in a manner that others can understand, and ability to understand and interpret complex information from others.Successful record of managing multiple projects with demonstrated ability to work independently in rapidly changing environments.-
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