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We’re reimagining health care with a primary care-led, value-based care model. Committed to serving all patients and working with all payers, VillageMD consistently innovates value-based care, bringing integrated applications, population insights and staffing expertise to its owned and affiliated practices, ensuring high-quality care, better patient outcomes and a reduction in the total cost of care.
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As part of Humana's Primary Care Organization, which includes CenterWell Senior Primary Care, Conviva's innovative, value-based approach means each patient gets the best care, when needed most, and for the lowest cost.
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Strong understanding of Patient-Centered Medical Home (PCMH) principles and value-based care. Participate in quality improvement initiatives and value-based care programs.
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Perform chronic care management for patients with conditions such as hypertension, diabetes, and asthma. Proficient in providing comprehensive primary care, including chronic care management, annual wellness visits for adults and pediatrics, and preventive health measures.
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The mission of the Data Organization within Nuna is to empower industry-wide value-based care adoption by leveraging data-driven insights for the enhancement of value-based payment operations, population management, decision making, and patient outcomes in an efficient, secure, and ethical manner.
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Strong understanding of value-based care models, population health management, and quality improvement methodologies. 2 years of relevant experience in value-based care/quality improvement role.
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Reporting into the Medical Value Liaison Field Director, the Senior Medical Value Liaison (MVL)/Executive MVL is a field-based role focused on applying clinical expertise and experience/knowledge of payors, health policy, payer utilization management, and pharmacoeconomics to strategically support Karuna’s scientific strategy and business objectives.
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Experience in leadership and oversight of segment leaders and strategic direction of clinical, quality, and population health programs across care management, utilization management, quality, and value based care.
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Experience in population health and value-based care data repositories, third party software tools, and working with payer claims datasets highly preferred. This role assists the Chief Population Health and Growth officer and team during risk-based contract negotiations to ensure successful contract negotiation and monitoring and enforcement of contract terms and support for value base care contracting initiatives.
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Collaborates with HWD and/or RN Care Manager to ensure compliance with service plans, while working with providers to attain value-based outcomes for our residents. Knowledge of value-based care models is preferred.
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Preferred experience working in Value Based Care or Population Health including documenting and coding from a MA (Medicare Advantage) risk perspective and conducting Health Risk Assessments on high risk/chronically ill patients.
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Support system enhancements to align with population health management and value-based care initiatives. Ensure effective utilization and optimization of the Epic Tapestry system to support managed care operations and population health management.
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Partners with local SPHS leadership and acts as Medical Director for the SPHS Value-Based Care Management team responsible for GMG patients. Guides the creation and implementation of new clinical care delivery models at SGMF focused on the provision of superb clinical care in a “Value-Based Care / Population Management” environment.
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Serves as a subject matter expert in quality and value-based care programs such as MIPS, ACOs, and payor pay-for-performance contracts. Schedules appointments related to preventive care, chronic disease management, and/or integrated behavioral health.
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The GMG Accountable Care Medical Director (ACMD) is responsible for the creation, guidance, and implementation of new models of clinical care that will promote quality and affordability in a Value-Based Care model that meets employers, payers, and individual patients demands for high value, integrated, affordable care.
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