The MSO Value-Based Care (VBC) Program Specialist I is responsible for providing support for the various Medicare and Medi-Cal VBC programs' performance and improvement activities that include facilitation of program implementation and monitoring of intervention activities, validation of data, and reporting of VBC program outcomes to contracted Health Plan(s).
They are required to be able to effectively communicate with a variety of professionals, including physician providers, health plan program administrators, and other NEMS internal departmental managers and staff, to promote effective program activities and achieve optimal program outcomes.
ESSENTIAL JOB FUNCTIONS:
- Participate in the various Medicare and Medi-Cal VBC programs and activities for inter-rater reliability studies, provider utilization studies, and other surveys and studies.
- Compile and review statistical data collected from medical records, logs, and database studies that support the VBC programs and improvement measures.
- Coordinate intervention activities as recommended and designed by the NEMS Practice Improvement Program (PIP) committee and monitor improvement outcomes.
- Perform outreach activities via phone, mail, email, and/or any other virtual platform as suited for the project to improve measurement outcomes.
- Identify and report to supervisor of all data integrity issues and opportunities for improvement; make recommendations to NEMS PIP Committee as desired.
- Compile reporting summaries and develop effective and optimal visual display to inform internal and external business partners about findings.
- Collaborate with physicians, staff, and external organizations on all VBC related program activities and communicate requirements implemented by Managed Care Plan(s).
- Participate in internal and external committees and prepares meeting materials as needed.
- Submit VBC program reports related to quality improvement and progress summaries to internal and external business partners as required in a timely manner.
- Performs other job duties as required by manager/supervisor.