Program Manager, Value Based Care

Responsible for coordinating, implementing, evaluating and revising HPSM’s value-based care initiatives on an ongoing basis. This role will directly contribute to advancing the “quadruple aim” of healthcare including the health of HPSM’s member population, member experience, provider experience, and financial stability.    Position overview Plan, execute, and implement HPSM’s alternative payment models and value-based programs from design through ongoing evaluation and maintenance. Educate and work with provider and vendor partners to identify innovation opportunities and improve processes that advance the quadruple aim. This includes leading outreach and education efforts to provider practices with low levels of engagement in HPSM’s value-based programs. Support and/or lead the implementation of technology solutions that enable better population health management and the closure of care gaps, for HPSM providers or staff; this includes serving as the non-technical business lead to gather requirements and track project deliverables, managing vendor relationships, and acting as a liaison and key point of contact for providers implementing new tools. Develop and implement methods for monitoring the outcomes of value-based payment models across the “quadruple aim”; establish evaluation criteria appropriate to each program. Measure and report out on value-based payment program results internally and externally, including by developing and utilizing dashboards to track key performance indicators, and by synthesizing data and qualitative information into summarized results for diverse audiences. On an ongoing basis, engage with internal and external stakeholders to capture input into HPSM’s value-based payment program design to better align reimbursement with organizational goals and the external regulatory environment; at least annually, review and align on program design modifications such as specific quality measures included within a given payment program. Establish HPSM partnerships with relevant local, state, and federal programs related to value-based care; ensure HPSM programs are aligned with relevant regulatory and industry trends, while also serving as a subject matter expert to policy makers where appropriate. Participate cross-functionally in business planning to support HPSM initiatives, serving as a lead on provider-level interventions. Serve as an organizational subject matter expert on provider incentives, alternative payment methodologies, provider engagement, and the financial structures of contracted relationships.   Secondary Functions: Identify and implement opportunities to improve encounter data exchange between providers and HPSM, with a focus on increasing accuracy and completion. Perform other duties as assigned.   Requirements These are the qualifications typically needed to succeed in this position. However, you don’t need to meet every requirement to apply.  Education and experience are equivalent to: Bachelor’s Degree in Business Administration, Economics, Public Health, Health Care Management, Public Policy, or related field. Minimum three (3) years of program management or large-scale project-management experience. Experience with quality improvement and process improvement techniques. Master’s Degree in related field preferred. Experience with Medicaid managed care and/or Medicaid or Medicare populations.   Knowledge of: Value-based care programs and theories of behavioral change. Quality measurement (e.g. HEDIS, eCQM). Financial, quantitative, and contracting methodologies. Process improvement, redesign and change management principles. Project management and program evaluation methodologies. Quantitative and qualitative research and evaluation methods. Medicare and Medi-Cal regulations. Accrediting body requirements such as NCQA. Personal computers and proficiency in Microsoft Office Suite applications, including Outlook, Word, Excel, and PowerPoint.   Abilities: Influence results without authority, utilizing both strong project management and relationship management skills. Engage in critical thinking and creative problem solving, appropriately adjusting program priorities to meet business needs. Work cooperatively as part of a team and support team decisions. Communicate effectively, both verbally and in writing. Adapt to changes in requirements/priorities for daily and specialized tasks. Think critically and make informed decisions.   Skills: Relationship-building and interpersonal skills. Organizational behavior skills, with a focus on driving results.   Salary and benefits The starting salary range is $89,554 - $118,659 per year, depending on the candidate’s work experience. Excellent benefits package includes: HPSM-paid premiums for employee’s medical, dental and vision coverage (employee pays 10% of each dependent’s premiums) Fully paid life, AD&D and LTD insurance Retirement plan (HPSM contributes equivalent of 10% of annual compensation) 12 paid holidays a year, 12 paid sick days a year and paid vacation starting at 16 days a year Tuition reimbursement plan Employee wellness program It is HPSM's policy to provide equal employment opportunity for all applicants and employees.  HPSM does not unlawfully discriminate based on race, religion, color, national origin, ancestry, physical disability, mental disability, medical condition, marital status, sex, age, sexual orientation, veteran status, registered domestic partner status, genetic information, gender, gender identity, gender expression, or any other characteristic protected by applicable federal, state, or local law.  HPSM also prohibits discrimination based on the perception that an applicant or employee has any of those characteristics or is associated with a person who has or is perceived to have any of those characteristics.