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Employment Type:

Full time

Shift:

Description:

As an integral team member of MercyOne Population Health Services Organization (PHSO), the ACO Business Partner is responsible for driving statewide performance excellence in value-based contracts (VBC) and oversight of related improvement strategies. Working directly with PHSO senior leadership, The ACO Business Partner will optimize value-based revenue through identification of improvement opportunities, interpretation of payer data, and VBC contract terms negotiation. This individual will play a crucial role in mobilizing regional and local teams, leadership, providers and payer partners to improve quality and financial outcomes for the PHSO.

POSITION PURPOSE

As an integral team member of MercyOne Population Health Services Organization (PHSO), the ACO Business Partner is responsible for driving statewide performance excellence in value-based contracts (VBC) and oversight of related improvement strategies. Working directly with PHSO senior leadership, The ACO Business Partner will optimize value-based revenue through identification of improvement opportunities, interpretation of payer data, and VBC contract terms negotiation. This individual will play a crucial role in mobilizing regional and local teams, leadership, providers and payer partners to improve quality and financial outcomes for the PHSO.

ESSENTIAL FUNCTIONS

• Proactively monitor, identify and recommend statewide value based performance improvement opportunities, working collaboratively with medical group and care management leadership.

• Lead internal and external working groups and/or strategic initiatives to improve statewide contract performance.

• Oversee the analysis and interpretation of clinical, cost, and utilization data to identify opportunities to maximize contract performance and revenue.

• Facilitates the development, maintenance and communication of monthly contract performance reports to MercyOne leadership.

• Maintains ‘Subject Matter Expert’ status for all statewide value based contracts, including contract terms, performance, payer reports, data, etc.

• Oversee payer reporting requirements including manual and automated supplemental data submissions, risk adjustment requirements, etc.

• Oversee financial performance monitoring and tracking/distribution of all value based payer payments

• Supports budget-setting process by recommending VBC revenue targets

• Serves as strategic thought partner of the PHSO leadership team, manage various workgroups and oversee compilation and polished communication of value based performance related materials to various stakeholders

• Liaise with and manage payers on financial performance, monthly contract performance meetings, and timely reporting mandates.

• Main escalation point to payers on issues relayed by the PHSO leadership team.

• Negotiate VBC terms and payer incentives to align with established PHSO care management and overarching MercyOne quality value-based strategies.

• Working collaboratively with Payer Strategies and Provider Network to evaluate the success of preferred payer and VBC arrangements.

LEADERSHIP COMPETENCIES

As a MercyOne Trinity Health Leader, the incumbent is expected to demonstrate leadership traits which support our Mission Statement and Core Values as identified below:

Mission Statement: We serve together in the spirit of the Gospel as a compassionate and transforming healing presence within our communities.

Core Values:

• Reverence: We honor the sacredness and dignity of every person.

• Commitment to Those Experiencing Poverty: We stand with and serve those who are poor, especially those most vulnerable.

• Safety : We embrace a culture that prevents harm and nurtures a healing, safe environment for all.

• Justice: We foster right relationships to promote the common good, including sustainability of Earth.

• Stewardship: We honor our heritage and hold ourselves accountable for the human, financial and natural resources entrusted to our care.

• Integrity: We are faithful to those we say we are.

MINIMUM QUALIFICATIONS

Education: Bachelor’s Degree with an emphasis in Business, Health Care or related field, required. Master’s Degree strongly preferred or comparable work experience required.

Experience: Three years of relevant experience required. Previous supervision experience required. Strong payer management experience required.

Licensure or Certification: N/A

Knowledge & Skills:

Excellent communication, negotiation and group/meeting facilitation skills required. Experience managing health care contracts required; experience with managing and optimizing value based contracts strongly preferred. Experience with value-based contract data (e.g. claims, EMRs, etc.) and business analytics (i.e. reporting, analysis, operational insights) required. In-depth knowledge of HEDIS measures strongly preferred. Strong skills in MS Office suite (Excel, PowerPoint Word, Outlook) required. Strong skills in managing competing priorities, time management and prioritization required. Experience with consulting, project management and/or process improvement (PDSA, Lean, or Six Sigma) preferred. Experience developing health care strategies and implementing projects focused on the Triple Aim (Quality, Cost, Experience) preferred.

PHYSICAL AND MENTAL REQUIREMENTS AND WORKING CONDITIONS

Must be able to pass a pre-employment health and drug screening at time of hire. Frequently required to carry or lift items weighing up to 10 pounds. Occasionally required to carry or lift items weighing up to 25 pounds for short distances. Occasionally required to stand or walk. Frequently required to sit in a stationary position. Occasionally performs activities that require stooping, bending and reaching, squatting, balancing, and trunk twisting throughout the day. Frequently able to detect and discern both loud and soft sounds such as phone calls and customer questions. Constantly able to use hands and fingers to type, write, and file. Frequently able to use near vision for viewing computer monitor and written materials. Occasionally required to detect unusual odors that could indicate environmental issues. Must be able to travel to the various MercyOne sites as needed. Must possess the ability to comply with MercyOne policies and procedures.

Our Commitment to Diversity and Inclusion

Trinity Health is one of the largest not-for-profit, Catholic healthcare systems in the nation. Built on the foundation of our Mission and Core Values, we integrate diversity, equity, and inclusion in all that we do. Our colleagues have different lived experiences, customs, abilities, and talents. Together, we become our best selves. A diverse and inclusive workforce provides the most accessible and equitable care for those we serve. Trinity Health is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, status as a protected veteran, or any other status protected by law.

Our Commitment to Diversity and Inclusion

Trinity Health is a family of 115,000 colleagues and nearly 26,000 physicians and clinicians across 25 states. Because we serve diverse populations, our colleagues are trained to recognize the cultural beliefs, values, traditions, language preferences, and health practices of the communities that we serve and to apply that knowledge to produce positive health outcomes. We also recognize that each of us has a different way of thinking and perceiving our world and that these differences often lead to innovative solutions.

Our dedication to diversity includes a unified workforce (through training and education, recruitment, retention, and development), commitment and accountability, communication, community partnerships, and supplier diversity.

EOE including disability/veteran