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Value-Based Care Consultant
Highmark Health. Collaborate with participating Clinical Integration Network practices, institute stakeholders, regional concierge team, and CIN leadership to implement clinical integration and Value-Based Reimbursement optimization initiatives .
Core Competencies
Role fitCore Competencies
Use this summary to align your resume positioning with the role.
Demonstrates expertise in population health management and value-based reimbursement strategies, with a strong focus on patient-centered care and clinical integration. Proficient in analyzing practice performance data and fostering collaboration among healthcare teams to optimize outcomes and operational efficiency.
Highest-signal resume keywords
Population Health ManagementValue-Based ReimbursementPatient-Centered Medical Home PrinciplesHealthcare Data AnalysisHIPAA Compliance
ATS Keywords
Tailor your resumeApplicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills
Clinical IntegrationCost/Utilization ReportingPractice Performance AnalysisWorkflow OptimizationEHR Technology Utilization
Soft Skills
CollaborationRelationship BuildingTraining and EducationStrategic PrioritizationCommunication
Tools & Technologies
Analytics TechnologyPractice Management Software
Certifications & Qualifications
PA Registered Nurse License
Industry Keywords
Value-Based CareHealthcare OutcomesClinical QualityCare Management ProgramsCompliance
About the role
Key responsibilities & impact- Collaborate with participating Clinical Integration Network practices, institute stakeholders, regional concierge team, and CIN leadership to implement clinical integration and Value-Based Reimbursement optimization initiatives
- Encourage physicians and care teams to improve healthcare outcomes while containing healthcare costs
- Develop and implement strategies promoting value-based, patient-centered care and CIN goals
- Cultivate relationships with assigned practices, institutes, and regional partners through in-person meetings and collaboration
- Set strategic priorities, report results, and identify improvement opportunities
- Train assigned practices and/or institutes to use and understand CIN cost/utilization reports and analytics technology
- Analyze practice performance reports and data to identify opportunities, develop practice-specific action plans, and implement strategies to achieve CIN VBR goals
- Train teams and foster adoption of optimized workflows, panel management techniques, EHR technology utilization, and education on regional quality, cost, and utilization opportunities
- Collaborate with regional operations teams and Local Advisory Council leaders to develop POD-specific goals and clinical integration strategies
- Prepare Local Advisory Council presentations and progress reports; participate in regional quality councils when applicable
- Perform practice capability assessments and develop comprehensive analyses of findings
- Serve as liaison for care path implementation and care management programs by facilitating introduction and implementation within practices
- Participate in regional practice manager educational programs, webinars, learning collaboratives, and dissemination of best-practice workflows and strategies
- Participate in regional CIN operations, institute leadership, and corporate team meetings
- Perform other duties as assigned or requested
Requirements
What you’ll need- Bachelor’s degree in a health-related field or relevant experience and/or education as determined by the company in lieu of a bachelor's degree
- 5 years of population health management principles or related clinical quality or practice operations experience
- Preferred: 1 year of pay-for-value programs/payer contracts experience
- Preferred: 1 year of experience with Patient-Centered Medical Home principles
- Preferred: PA Registered Nurse license
- Compliance with HIPAA, data security guidelines, the Company’s Code of Business Conduct, and applicable federal and state laws, rules, and regulations
- Ability to protect covered information, cardholder data, and confidential customer information
Benefits
Comp & perks- No specific benefits or compensation extras stated in the posting