Director ACO Operations

🕒 il y a 8 jours

🇺🇸 États-Unis – Télétravail

⏰ Temps Plein

🔴 Expert

⚙️ Opérations

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Chamber

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1 - 10 employés

🏥 Santé

⚕️ Assurance santé

☁️ SaaS

Healthcare • Healthcare Insurance • SaaS

Chamber est une entreprise axée sur l'amélioration de la santé cardiovasculaire en permettant aux équipes de cardiologie de prospérer dans un environnement de soins basés sur la valeur. Elle s'associe avec des cardiologues pour offrir des solutions technologiques et des services de soutien qui permettent des soins complets et ouvrent de nouvelles opportunités de revenus, sans frais pour la pratique. Chamber aide à naviguer dans les soins basés sur la valeur grâce à des insights en temps réel, un soutien administratif et une expertise dans les négociations avec les payeurs. Avec un réseau solide de cardiologues performants et des partenariats avec des systèmes hospitaliers, Chamber transforme l'écosystème des soins en cardiologie pour s'assurer que les prestataires sont rémunérés pour fournir les soins appropriés au bon moment.

Description

• Launch Chamber’s ACO and own its performance, holding the operating model, workflows, and controls to a high standard as the network scales. • Prove the specialty-focused model in cardiology, using early results to shape how the network grows. • Own the CMS submission and enrollment cycle end to end, building the calendar and controls that keep every filing accurate and on time. • Serve as the operational and analytic engine of the ACO, exercising independent judgment on performance, compliance, and provider success. • Establish and manage ACO governance — the committee structures, decision rights, and reporting cadences that keep the entity accountable and audit-ready. • Own regulatory compliance across the program (e.g., MSSP, ACO REACH), monitoring requirements and adapting operations to policy changes. • Serve as Chamber’s representative to CMS, federal agencies, and external partners on matters affecting ACO outcomes. • Partner with Finance and Provider Network to design and run payment operations, translating value-based contracts into working financial workflows — attribution, reconciliation, and settlement. • Track performance against financial and contractual metrics, surfacing risks and opportunities to leadership with clear, data-grounded recommendations. • Partner with Clinical and Network teams to improve network performance against quality, cost, and utilization targets. • Analyze performance data to develop strategic recommendations on ACO operations, quality improvement, and total cost of care.

🎯 Exigences

• 6–10+ years in healthcare operations, with meaningful time in value-based care, population health, or ACO/managed care. • Deep knowledge of Medicare value-based programs (e.g., MSSP, ACO REACH, Medicare Advantage) and their CMS requirements. • Track record of independently owning and scaling complex operational initiatives to measurable outcomes. • Strong command of payment operations and value-based contract mechanics. • Highly analytical, and comfortable in the data yourself — manipulating large files and datasets without waiting on others. • Clear communicator who can distill complex program rules and payment mechanics into sharp takeaways for executive audiences. • Entrepreneurial operator who does their best work amid ambiguity and is accountable for outcomes, not activity.

🏖️ Avantages

• 6–10+ years in healthcare operations, with meaningful time in value-based care, population health, or ACO/managed care. • Deep knowledge of Medicare value-based programs (e.g., MSSP, ACO REACH, Medicare Advantage) and their CMS requirements. • Track record of independently owning and scaling complex operational initiatives to measurable outcomes. • Strong command of payment operations and value-based contract mechanics. • Highly analytical, and comfortable in the data yourself — manipulating large files and datasets without waiting on others. • Clear communicator who can distill complex program rules and payment mechanics into sharp takeaways for executive audiences. • Entrepreneurial operator who does their best work amid ambiguity and is accountable for outcomes, not activity.