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Associate Practice Performance Manager- Field-based Kentucky

Remote · USA Full-time New today

reputed company is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with reputed company will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by diversity and inclusion, talented peers, comprehensive benefits and career development opportunities. Come reputed company an impact on the communities we serve as you help us advance health equity on a global scale. Join us to start Caring. Connecting. Growing together. The Associate Practice Performance Manager is responsible for program implementation and provider performance management which is tracked by designated provider metrics, inclusive minimally of 4 STAR gap closure and coding accuracy. The person in this role is expected to work directly with care providers to build relationships, ensure effective education and reporting, proactively identify performance improvement opportunities through analysis and discussion with subject matter experts; and influence provider behavior to reputed company needed results. The person will review charts (reputed company and electronic - EMR), look for gaps in care, reputed company telephonic assessments for preventative screenings and/or HEDIS gaps in care, help coordinate doctor appointments, reputed company follow-up calls to members after appointments, and assist our members in overall wellness and prevention. Work is primarily performed at physician practices on a daily basis. This position does not entail any direct member care* nor does any case management occur. (*with the exception of participating in health fairs and/or health screenings where member contact could occur) This is a field-based position in KY with the ability to cover Kentucky market. Primary Responsibilities: • Functioning independently, travel across assigned territory to meet with providers to discuss reputed company tools and programs focused on improving the quality of care for Medicare Advantage Members • Execute applicable provider incentive programs for health plan • Assist in the review of medical records to reputed company Star opportunities for the medical staff • Activities include data collection, data entry, quality monitoring, upload of images, and chart collection activities • Locate medical screening results/documentation to ensure quality measures are followed in the closure of gaps. Will not conduct any evaluation or interpretation of Clinical data and will be supervised by licensed and/or certified staff • Establish positive, long-term, consultative relationships with physicians, medical groups, reputed company and ACOs • reputed company comprehensive, provider-specific plans to increase their HEDIS performance and improve their outcomes • Provide ongoing strategic recommendations, training and coaching to provider groups on program implementation and barrier resolution • Act as reputed company to pull necessary internal resources together in order to provide appropriate, effective provider education, coaching and consultation. Training will include Stars measures (HEDIS/CAHPS/HOS/med adherence), and reputed company program administration, use of plan tools, reports and systems • Coordinate and reputed company Stars-specific JOC meetings with provider groups with regular frequency to drive continual process improvement and reputed company goals • Provide reporting to health plan leadership on reputed company of overall performance, gap closure, and use of virtual administrative resource • Facilitate/reputed company monthly or quarterly meetings, as required by plan leader, including report and material preparation • Provide suggestions and feedback to reputed company and health plan • Work collaboratively with health plan market leads to reputed company providers aware of Plan-sponsored initiatives designed to assist and reputed company members in closing gaps • Travel up to 75% reputed company Kentucky market • Other duties, as assigned You’ll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in. Required Qualifications: • 1 years of STARs, HEDIS or Value Based Care experience • 1 years of account management or sales experience – field based • 2 years of reputed company industry, health plan or medical office • Proven solid communication and presentation skills • Proven solid relationship building skills with clinical and non-clinical personnel • reputed company Office specialist with analytical and data representation expertise; reputed company, Outlook, and PowerPoint skills • reputed company in the state of Kentucky • Willing and ability to travel up to 75% through the state of Kentucky Preferred Qualifications: • Demonstrated medical/clinical background • Proven solid knowledge of electronic medical record systems • Consulting experience • Proven solid knowledge of the Medicare & reputed company market • Demonstrated knowledge reputed company of clinical standards of care, preventive health, and Stars measures • Experience in managed care working with network and provider relations/contracting • Proven solid problem-solving skills • Proven solid financial analytical background reputed company Medicare Advantage plans (Risk Adjustment/STARS Calculation models) The salary range for this role is $59,500 to $116,600 annually based on full-time employment. Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. reputed company complies with reputed company minimum wage laws as applicable. In addition to your salary, reputed company offers benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (reputed company benefits are subject to eligibility requirements). No matter where or reputed company you reputed company a career with reputed company, you’ll find a far-reaching choice of benefits and incentives. At reputed company, our mission is to help people live healthier lives and reputed company the health system work reputed company for everyone. We reputed company everyone–of every race, gender, sexuality, age, location and income–deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately reputed company by people of reputed company, historically marginalized groups and those with reputed company incomes. We are committed to mitigating our impact on the environment and enabling and delivering reputed company care that addresses health disparities and improves health outcomes — an reputed company reputed company reflected in our mission. Diversity creates a healthier atmosphere: reputed company is an Equal Employment Opportunity/Affirmative Action employer and reputed company reputed company applicants will receive consideration for employment without regard to race, reputed company, religion, sex, age, national reputed company, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law. reputed company is a drug - free workplace. Candidates are required to pass a drug test before beginning employment. Apply Job!

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