Manager, Provider Performance Engagement

🕒 Outubro 14

🏈 Ohio – Remoto

🏈 Ohio – Remote

💵 $83.000 - $132.800 / ano

⏰ Tempo Integral

🟡 Pleno

🟠 Sênior

👔 Gerente

🦅 Patrocina Visto H1B

Esta empresa já patrocinou vistos H1B no passado.

👻 Score fantasma 24%

O que significa: a chance de ninguém estar realmente contratando para esta vaga.Como ler: 60% ou mais significa que achamos que é uma vaga fantasma. Pontuações mais baixas preocupam menos.Por que essa pontuação:

• Aberta há 28 dias.
• As vagas desta empresa costumam ser preenchidas em 21 dias.
• Repostada 2 vezes.

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CareSource

SiteLinkedInTodas as Vagas

1001 - 5000 funcionários

Fundada em 30+ years

🏥 Saúde

🛡️ Seguros

⚕️ Seguro de Saúde

Healthcare • Insurance • Healthcare Insurance

CareSource é uma empresa de serviços de saúde focada em fornecer soluções acessíveis de seguro saúde e assistência médica. Oferece uma ampla gama de planos, incluindo Medicaid, Marketplace e Medicare Advantage, direcionados a adultos de baixa renda, famílias, crianças, gestantes, idosos e pessoas com deficiência. Além disso, a CareSource oferece aos membros recursos para suporte ao COVID-19, benefícios odontológicos, de visão e audição, bem como serviços de farmácia. A empresa enfatiza o fácil acesso ao gerenciamento de saúde por meio de plataformas online e um aplicativo móvel.

Descrição

• Oversee performance engagement activities with internal and external partners • Establish and execute detailed provider performance engagement plans for new and existing providers • Manage customized provider plans supporting key quality metrics and positive outcomes • Manage provider onboarding and oversight process development • Ensure compliance with state, federal, and regulatory body requirements • Develop and maintain departmental policies and procedures for oversight of contracted providers in an Alternative Payment Model (APM) • Analyze, update, and modify procedures to improve engagement processes • Review and incorporate data analysis for program metrics, outcome measures, results, and savings opportunities • Manage financial ROI, quality metrics, and service level agreements to evaluate provider engagement initiatives • Identify and manage risks associated with process changes, implement mitigation strategies, and communicate or escalate to stakeholders • Report provider APM program progress and oversight status to stakeholders • Ensure provider performance engagement milestone deliverables are completed for each project phase • Maintain strategic alignment when prioritizing projects using the established RACI document • Participate in Provider Oversight Committee meetings with internal business owners and providers • Provide leadership guidance to support staff career growth • Oversee day-to-day staff activities and department goal achievement • Manage staff objectives and prioritization in alignment with market and corporate goals • Perform other job-related instructions as requested

🎯 Requisitos

• Must reside in Ohio • Bachelor's degree or equivalent years of relevant work experience required • Minimum of five (5) years of experience working collaboratively with external Health Partners required • Familiarity with the healthcare field and experience with payer-provider integration required • Proficiency in Microsoft Office tools, including Project, Word, and Excel • Thorough understanding of project management processes, techniques, and tools • In-depth knowledge of regulatory and quality standards and measures, including State Medicaid programs, Medicare, and Quality Accreditation (e.g., ODM, CMS, NCQA, URAC) • In-depth knowledge of Patient Centered Medical Home (PCMH) concepts and processes • Excellent written and verbal communication skills • Strong interpersonal and relationship-building skills • Ability to work independently and within a team environment • Ability to multitask and prioritize work to meet project deadlines • Effective listening and critical thinking skills • Time management skills • Customer service orientation • Decision-making and problem-solving skills • Excellent planning, negotiating, and influencing skills • Annual influenza vaccination required during influenza season as a condition of continued employment • Master's degree in business or health-related field preferred • Minimum of one (1) year leadership/management experience preferred

🏖️ Benefícios

• Bonus tied to company and individual performance • Comprehensive total rewards package • Annual influenza vaccination requirement covered as a condition of continued employment • Reasonable accommodations for qualified individuals with disabilities, medical conditions, or sincerely held religious beliefs

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