Senior Value-Based Contract Performance Consultant

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Job Description Summary:

The Senior Consultant, Value Based Contract Performance is charged with supporting teams in solving complex problems focused on improving performance on value-based contracts or alternative payment programs in the Medicare, Commercial and Medicaid spaces as OhioHealth transitions from a volume to value clinical delivery model. This includes the OhioHealth Clinically Integrated Network (CIN) Medicare Advantage and Commercial contracts, OhioHealth Venture Medicare Shared Savings Program Accountable Care Organization (ACO), CMS Bundled Payments for Care Improvement initiative, CMS Radiation Oncology Model, Medicaid contracts, and other initiatives as they arise.

This position will support Advisors, Senior Advisors, and Directors charged with convening provider and administrative team members to drive successful change that supports the ability of value-based models to deliver on the value equation of quality, service, and cost efficiency.
This position reports to the Advisor, Value Based Contract Performance and is accountable for supporting teams to achieve cost and quality targets within our value-based contracts and programs.

Key responsibilities include:
• Supporting the team accountability of value-based contract performance in the Medicare, Commercial and Medicaid spaces by aligning and convening teams responsible for performance within components of the value-based contract
• Analyzing and synthesizing data (e.g., population health utilization, cost, benchmarking reports) to communicate contract performance and advise on next steps required to achieve metrics. Specifically, drawing inference from data sets to support the recommendation of strategies and tactics to better achieve contract objectives
• Supporting the development of quantitative and qualitative evaluations and scenario modeling for contract/program participation in order to generate recommendations to leaders within and beyond Population Health Services; these evaluations will include operational feasibility, financial implications (ROI), physician impact, and general pros and cons
• Describing value-based contract targets / goals and current performance.
• Supporting cross-functional teams in initiatives and programs to help to achieve contract targets
• Documenting standard work for successful initiatives and building processes to ensure program sustainability
• Supporting physician and administrative committees focused on monitoring/ improving contract performance
• Analysis of federal, state, and local policy that impacts value-based contracts
• Serving as key point of contact to payers around value-based contracts

Responsibilities And Duties:

70%: Supporting multiple teams to describe and improve value-based contract / program performance
·       Coordinates and monitors program performance and continuous improvement initiatives
·       Participates in data collection, analyses, and interpretation of analyses for program planning purposes
·       Serves as subject matter expert and interpreter of value contracts and programs to support the description of what we need to accomplish and subsequent stakeholder decisions.
·       Promotes working relationships with other interdependent OhioHealth departments
·       Participates in strategic planning
·       Actively participates in team activities such as Gemba walks, team huddles, and team-building sessions to foster growth, development, and team effectiveness.
 
30%: Medicare, Medicaid, and commercial program knowledge
·       Analyze and communicate relevant policy updates in the value-based payer space, including Medicare, commercial and Medicaid
·       Advise how program and policy changes would impact OhioHealth CIN day-to-day operations and performance

Minimum Qualifications: