VP of Value-Based Care Operations

Clinical Leader – GUIDE Model & Value-Based Care Initiatives

 

Position Type: Full-time

Compensation: TBA

Job Location: Remote (US)

Job Highlights

• Work-Life Balance: Competitive compensation with balanced hours.
• Patient-Centered Care: Directly impact patient outcomes through chronic care management.
• Remote Flexibility: Work from the comfort of your home.
• Flexible Scheduling: Your schedule, tailored to fit your life. No set daily shift times.
• No Overnight Duties: Sleep peacefully with no overnight call/requirements.
• Meaningful Connections: Establish lasting relationships with patients and staff.
• Culture of Appreciation: Your work is valued and rewarded.
• Licensure Reimbursed: We cover your medical licensure costs.
• Benefits: 401k match, Medical/Dental/Vision, Disability, Employer-paid Life Insurance.
• Referral Bonus: Earn more by expanding our team.
• Career Advancement: Leadership opportunities promoted.
• Continuous Learning: Opportunities for ongoing education and professional development, including coding and risk adjustment.

Essential Functions and Responsibilities

GUIDE Model Implementation & Oversight

• Lead the implementation of Theoria Medical’s participation in the CMS GUIDE Model, ensuring compliance with all CMS requirements and quality benchmarks.
• Develop and implement standardized protocols for Care Navigators and Respite Services to ensure high-quality, patient-centered dementia care.
• Oversee training and performance management for Care Navigators, ensuring they provide effective care coordination, caregiver education, and resource navigation.
• Monitor program performance, tracking key CMS quality metrics related to patient outcomes, caregiver burden reduction, and service utilization.
• Develop process improvement initiatives to enhance care delivery and reduce hospital readmissions among dementia patients.

Expansion of ACO Partnerships & Preferred Provider Strategy

• Develop and implement strategic relationships with ACOs to position Theoria Medical as their preferred provider for post-acute care services.
• Present Theoria Medical as the best-in-class solution for post-acute and transitional care, focusing on cost savings, quality improvement, and patient outcomes.
• Engage with ACO leadership and stakeholders to create value-based care alignment strategies that integrate Theoria Medical’s post-acute, and dementia care solutions into their networks.
• Track and report clinical and financial performance metrics to demonstrate Theoria Medical’s impact in reducing hospitalizations, improving care transitions, and optimizing total cost of care.

Care Navigator Training & Clinical Supervision

• Lead the training, onboarding, and ongoing education of Care Navigators to ensure they are well-equipped to provide high-quality care coordination and caregiver support.
• Implement telehealth and in-person visit protocols to ensure Care Navigators maintain consistent engagement with dementia patients and their caregivers.
• Conduct regular case reviews and quality audits to ensure compliance with CMS Dementia Care Management Payment (DCMP) guidelines and best practices in dementia care.

Respite Services Management & Optimization

• Oversee the allocation and administration of CMS-approved Respite Services to ensure optimal utilization and support for caregivers of dementia patients.
• Develop partnerships with community-based respite providers to expand access to in-home, adult day, and facility-based respite care options.
• Monitor service utilization, caregiver satisfaction, and financial sustainability of respite programs to drive continuous improvement.

Value-Based Care Strategy & Performance Optim