Value Based Care Manager - CMS TEAM Program

Overview:

The Value Based Care Manager plays a vital role in aiding the Director of Operations and the VBCI Senior Leadership Team by offering essential assistance. This position is crucial for meeting important milestones, ensuring timely delivery of key tasks, and effectively carrying out strategic plans. Responsibilities include overseeing project schedules, implementing programs, organizing collaborative efforts between departments, and spearheading initiatives that improve patient care and operational productivity.

We are looking for an energetic and seasoned Manager to oversee the execution and day-to-day functions of our fresh CMS TEAM (Transforming Episode Accountability Model) initiative. This position plays a crucial role in fostering achievements within an inventive value-based care framework that makes health systems answerable for the quality and expenses involved in designated clinical scenarios. The preferred candidate should possess a solid foundation in CMS initiatives, operational management of care models, and enhancement of performance. They will be accountable for establishing collaborative workflows, involving healthcare providers and operational heads, ensuring adherence to CMS guidelines, and supervising data-centered strategies to achieve quality and cost objectives. Succeeding in this position demands a combination of familiarity with healthcare regulations, effective team management, project administration skills, and the capacity to interpret intricate policies into feasible actions.

STRONGLY PREFERRED SKILLS and EXPERIENCE

• CMS Programs & Regulations

• Prior experience implementing or managing CMS models (e.g., MSSP, ACO REACH, Bundled Payments, Primary Care First, or other Innovation Center models).

• Deep understanding of CMS quality metrics, financial benchmarks, and compliance requirements.

• Care Model Implementation or Operations

• Operational leadership in care management, population health, or clinically integrated networks (CINs).

• Proven ability to build and operationalize workflows supporting patient identification, risk stratification, care coordination, and reporting.

• Cross-Functional Team Leadership

• Led multidisciplinary teams including clinicians, analysts, IT, and administrative staff.

• Experience driving change management across clinical and administrative stakeholders.

• Performance Management

• Experience developing KPIs, dashboards, and tracking tools to monitor program success.

• Experience with corrective action plans for underperformance.

Responsibilities:

Operational Support:

Support the Director of Operations in coordinating and supervising VBCI operations.

Observe and assess operational performance indicators while aiding in the recognition of areas that could be enhanced.

Organize and assist in carrying out the execution of operational guidelines and protocols.

Project Coordination:

Supervise and monitor the advancement of current initiatives, verifying their consistency with the objectives of the organization.

Arrange project discussions, create meeting outlines, and oversee tasks and goals within the project.

Support the exchange of information among departments to guarantee the timely accomplishment of project goals.

Administrative Duties:

Create documents, slideshows, and written communications for the Operations Director.

Organize and rank incoming inquiries and messages for the Director's attention.

Problem-Solving:

Deal with operational challenges and aid in creating strategies to enhance procedures.

Offer assistance in identifying and solving daily operational issues.

Interdepartmental Coordination:

Act as a communicator connecting different departments with the Operations Director.

Support seamless interaction and cooperation among different teams.

Adherence and Quality Control:

This phrase indicates the importance of following regulations and maintaining high standards in processes:

Help to guarantee adherence to both regulatory mandates and internal company protocols.

Back quality control efforts in order to improve patient care and operational effectiveness.

Qualifications:

EDUCATION:

Required:

• Bachelors degree in Healthcare Administration, Business Administration, or related field; relevant experience may be considered in lieu of degree.

EXPERIENCE:

Required:

• 3 years proven experience in a similar operational or administrative role Required, preferably within a healthcare or clinical setting.

LICENSURE/CERTIFICATION/REGISTRY/LISTING:REQUIRED

Valid Driver's License If driving Cone Health vehicle, must have 5 years of driving experience and MVR must be approved by Risk Management.