Hospital Value-Based Provider Performance - Market (must live in Nevada)- HYBRID
Core
Lead the implementation, monitoring, and optimization of hospital value-based payment programs to ensure contractual performance, quality outcomes, and financial targets are achieved for the Nevada market.
Role type
Senior market lead for hospital and provider value-based payment programs
Builds
Value-based payment arrangements and provider performance initiatives
Domain
Healthcare payer industry, Medicaid Managed Care, value-based reimbursement
Deliverable
production ML models | product features | dashboards & analysis | client delivery | infrastructure | physical/clinical work
Required skills
Value-based reimbursement design, VBR contracting, provider contracting, provider performance management, managed care operations, population health, healthcare quality metrics, Medicaid program knowledge, hospital and health system engagement, ACO experience
Preferred skills
Medicaid Managed Care program leadership, market-based provider incentive program leadership, state healthcare market knowledge, provider network management
Technologies
Microsoft Office (Word, Excel, PowerPoint)
Responsibilities
Lead implementation and optimization of value-based payment programs; Develop strategies to maximize quality withhold performance and return incentive payments; Serve as subject matter expert for internal stakeholders and contracted providers; Oversee provider participation, regulatory compliance, and reporting; Collaborate on care gap closure and utilization improvement; Monitor provider performance against quality metrics and facilitate action plans; Manage multiple projects and analyze data for reporting.
Seniority
Senior, hands-on IC with market leadership responsibilities
