Manager, Value-Based Care Operations

This is a fully remote position, open to applicants in United States.

📋 Description

• Oversee and manage the delivery of EMR and quality reports, ensuring timely distribution and follow-up.

• Provide education to ACO participating group operators and providers regarding quality measures, performance metrics, and reporting expectations.

• Investigate and address quality reporting gaps while enhancing data accuracy in collaboration with affiliate back-office teams.

• Gather and verify Social Determinants of Health data for regulatory and program reporting purposes.

• Assist with communications related to Promoting Interoperability and ensure appropriate follow-up.

• Extract, analyze, and disseminate monthly EMR reports.

• Review, compile, and confirm the accuracy of monthly quality and performance reporting packages.

• Guarantee the precise and timely delivery of billing bifurcation reports.

• Explore and rectify reporting discrepancies in collaboration with EMR vendors and external teams.

• Communicate reporting issues, corrections, and status updates to relevant stakeholders.

• Update and maintain the ACO Operations Manual.

• Identify, document, and execute new operational processes.

• Coordinate stakeholder feedback and process enhancements across various workstreams.

• Audit, sustain, and oversee Specialty Building tracking processes and databases.

• Prepare materials for external distribution and manage secure data submissions via SFTP.

• Evaluate monthly invoices and volume reports, providing recommendations for approval.

• Coordinate ongoing compliance activities, including maintaining vendor, TIN, and board member listings.

• Assist with compliance reporting and documentation efforts.

• Act as a reliable point of contact for ACO participating groups, providers, and vendors.

• Promote cross-department collaboration and deliver exceptional customer service while managing competing priorities.

⛳️ Requirements

• A Bachelor’s degree in Healthcare Administration, Business Administration, Public Health, Health Information Management, or a related field.

• 3–5 years of experience in healthcare operations, quality reporting, healthcare analytics, population health, value-based care, or a comparable healthcare setting.

• Proficient in Microsoft Excel, including working with large datasets, Pivot Tables, XLOOKUP/VLOOKUP, data validation, reconciliation, trend analysis, reporting, and data analysis.

• Practical experience with EMR/EHR systems and healthcare reporting data.

• Proven ability to analyze, validate, and distribute operational and quality reports.

• Experience collaborating directly with external affiliates, providers, vendors, and internal stakeholders.

• Capability to manage multiple projects, priorities, and deadlines in a dynamic environment.

• Strong analytical, problem-solving, critical thinking, written communication, and verbal communication skills.

• Excellent organizational skills and meticulous attention to detail.

• Ability to establish and maintain productive relationships with providers, affiliates, vendors, and cross-functional stakeholders.

• Strong customer service focus and capacity to manage stakeholder expectations.

• Preferred: experience in supporting ACOs, MSSP, population health, or value-based care programs.

• Preferred: experience in healthcare quality improvement and provider performance initiatives.

• Preferred: experience in working with EMR vendors and external healthcare organizations.

• Familiarity with CMS quality and reporting programs, including MIPS, PI, and SDOH.

• Knowledge of healthcare quality metrics, provider performance measurement, and regulatory reporting requirements.

• Understanding of operational process improvements and workflow optimization in healthcare settings.

• Must be eligible to work without visa sponsorship; the company cannot provide visa sponsorship.

🏝️ Benefits

• Competitive salary and performance-based bonuses.

• Comprehensive health insurance plans.

• Opportunities for professional development and career advancement.

• Flexible work schedule and remote work options.

• Supportive and collaborative work environment.