|
Purpose of Job The Manager Value-Based Programs is responsible for leading the strategic and operational execution of value-based care initiatives across the organization. This role focuses on optimizing performance under alternative payment models (APMs). including Accountable Care Organizations (ACOs), bundled payments, and risk-based contracts, while supporting cross-functional collaboration to improve quality outcomes and financial sustainability. Job Functions
- Lead the implementation and management of value-based programs such as payer incentive models, quality reporting initiatives, and alternative payment arrangements.
- Liaise with payer partners to understand contract requirements, performance expectations, and shared data insights.
- Translate payer-shared data into actionable information to inform organizational strategy, operational improvements, and clinical engagement.
- Monitor performance metrics and financial outcomes for value-based contracts; identify opportunities for improvement and lead corrective action plans.
- Collaborate with clinical, operational, and IT teams to ensure workflows, documentation, and billing practices align with program requirements.
- Serve as a subject matter expert on CMS regulations, payer requirements, and industry trends related to value-based care.
- Develop and maintain dashboards, reports, and presentations for internal stakeholders and external partners.
- Support provider engagement and education to drive adoption of value-based practices.
- Lead cross-functional projects that advance population health strategies and value-based care goals.
- Performs other duties as assigned.
Minimum Education/Work Experience
- Bachelor's degree in Nursing, Healthcare Administration, Public Health, or related field required
- Minimum of 5 years of experience in healthcare, with at least 2 years in value-based care, population health, or healthcare quality
Preferred License/Certification
- RN or other clinical licensure
- Certified Professional in Healthcare Quality (CPHQ)
- Project Management Professional (PMP) or similar credential
Preferred Qualifications
- Master's Degree in Healthcare Administration, Public Health, or related field
- Experience with payer contracting and performance-based incentive models
- Familiarity with federal and state value-based care initiatives
Knowledge/Skills/Abilities
- Strong understanding of CMS programs, risk adjustment, and alternative payment models
- Proven ability to lead cross-functional teams and manage complex projects, including quality performance
- Excellent communication, analytical, and organizational skills
- Ability to interpret and apply payer shared data to drive performance improvement
- Experience with Epic systems, data analytics tools, and payer portals preferred
Link to Physical Demands Compensation Many factors are taken into consideration when determining compensation such as: the requirements of the position, experience, education, knowledge, and skills along with location and internal equity. Pay listed does not include any shift, weekend, or other differentials. Benefits Ridgeview strives to provide comprehensive and market competitive benefits to meet the needs of our employees and their families.Click here to view the benefits available.
|
Ridgeview Medical Center
Oct 13, 2025