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5+ years of experience in managed care operations, provider reimbursement and analytics, and value-based care. This position will be responsible for leading the beginning-to-end operational support of specialty Medicaid value based payment (VBP) models in alignment with segment strategy and goals.
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Retrieves and analyzes data from NHSN (National Healthcare Safety Network) and reporting platforms such as PowerBI, Crystal Reports, Epic Cogito reporting tools, CMS Core Measures, nursing and surgical databases such as NDNQI (National Database of Quality Indicators) and NSQIP (National Surgical Quality Improvement Program) and Value-Based Care contracts and incentive programs.
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These laws and regulations require Pfizer to provide government agencies with information such as a health care provider's name, address and the type of payments or other value received, generally for public disclosure.
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In todays value-based care environment, WellSky helps providers, payers, health systems, and community organizations solve tough challenges, improve collaboration for growth, harness the power of data analytics, and achieve better outcomes by further connecting clinical and social care.
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The healthcare data analytics team supports UTP quality initiatives, payer contracts, value-based care programs, revenue cycle and operations by delivering reporting and business intelligence solutions to the organization.
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Possessing working experience in Payer or Provider operations (domain areas such as Medical Management, Population Health Management, Utilization Management, Provider Network Management, Value-Based Contracting, Provider Relations, Quality Improvement, Informatics, ACO operations, etc.
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These experiences range from efficiently analyzing and acting upon the operational health of hospital systems or entire nations of citizens to recommending tailored care plans for specific patients, thereby effectively managing chronic diseases and closing care gaps within a value-based care system.
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Pharmacy Care Management, Lower Costs, Concierge Service, Evidence-based Clinical Care, Real-time Analytics, Flexible Plan Options, Real-time Analytics, Proactive Oversight, Alignment, Client Services, Member Care, Pharmacy Benefits, Pharmacy Benefit Management, and Specialty Care Management.
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The Value-Based Care Analyst may be reassigned duties and responsibilities at any time due to reasonable accommodation or other staffing reasons. CareSTL Health is seeking a Value Care Base Analyst-The Value-Based Care Analyst collects and analyzes raw data to identify trends, patterns, anomalies, and other helpful information.
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Develop and communicate a product roadmap as it relates to solutions supporting hospital coding, physician coding, and modular coding offerings; articulate the unique value proposition based on deep understanding of medical coding and coding technology, coding audits, upstream real-time coding as well as safety net coding solutions, the complex medical coding landscape, and operational opportunities.
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Northern Light Health Department: Managed Care ContractingPosition is located: Cianchette Professional BldingWork Type: Full TimeHours Per Week: 40 hours weeklyWork Schedule: 7:30 AM to 5:00 PMSummary:The Director of Payer Strategy & Managed Care operations (PSMCO) oversees all aspects of payer contracting and relations with responsibility for the strategy, negotiation and execution of fee-for-service and value-based contracts for Northern Light Health and its subsidiary member organizations.
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Understanding of Healthcare Economic data, Health Systems, IDNs, Large Group Practices and Value-Based Care initiatives preferred. This individual will put the IAE team in the best position to win by driving strategic direction, leading product teams, and creating targeted, evidence-based product and economic messaging to deliver value to our customers.
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With Oracle Cerner's innovative technology, we seamlessly package this valuable information into a range of services and solutions that integrate seamlessly into your favorite analytics tools, EHR applications like Millennium, and new, groundbreaking applications.
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We were founded in 2014, and since then, we've become the largest network of independent primary care in the country - helping practices, health centers and clinics deliver better care to their patients and thrive in value-based care.
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Curana Health is a provider of value-based primary care services exclusively for the senior living industry, including in nursing homes, assisted/independent living facilities, CCRC/life plan communities and affordable senior housing communities.
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