Vice President, Value-Based Care Performance

Prominence Health is a value-based care organization bridging the gap between affiliated health systems and independent providers, building trust and collaboration between the two. Prominence Health creates value for populations and providers to strengthen integrated partnership, advance market opportunities, and improve outcomes for our patients and members. Founded in 1993, Prominence Health started as a health maintenance organization (HMO) and was acquired by a subsidiary of Universal Health Services, Inc. (UHS) in 2014. Prominence Health serves members, physicians, and health systems across Medicare, Medicare Advantage, Accountable Care Organizations, and commercial payer partnerships. Prominence Health is committed to transforming healthcare delivery by improving health outcomes while controlling costs and enhancing the patient experience.

Learn more at: https://prominence-health.com/

Job Summary:

The Vice President of Value-Based Care provides strategic leadership and ownership of all risk-based payer performance, value based growth and development, and the risk adjustment programs within Riverside Medical Clinic (RMC). Emphasis will be centered around risk-based contract performance, risk adjustment, and close collaboration with RMC's leadership team to ensure high quality and total cost of care management. The most immediate focus for this position will be development of core operations within Riverside Medical Clinic to support the success and advancement of its risk based and value based strategy. Payer relationship management, contract-specific performance oversight, delegated operational responsibility performance and operational development of core risk adjustment and quality programs will be central to the success of this role. The objective of this position is to optimize clinical quality and revenue opportunities for RMC to drive reliable, scalable, high-performance growth of the business.

Key responsibilities include optimizing RMC's managed care lines of business through strategic payer development, optimization of capitation revenue through risk adjustment program success, top tier quality performance, and cost management through appropriate utilization and care management interventions. The Vice President of Value-Based Care has programmatic oversight and responsibility for achieving all risk adjustment, quality, and overall value based contract performance outcomes. The Vice President of Value-Based Care works closely with partner stakeholders and business leaders to ensure the development and implementation of population health and quality improvement initiatives aligned with RMC's, business, quality measurement, and improvement strategies. The Vice President of Value-Based Care will advise on best practices, leverage centralized UHS/Prominence Health resources, and enable RMC to develop the competencies and programs that will achieve top tier performance.

The VP of Value-Based Care will work collaboratively with other Prominence Health and UHS partner organizations, including Actuarial, IS, Analytics, Legal, Health Services, Network Management, Quality Improvement and others to leverage internal and external resources manage the various RMC programs. The role will be responsible to develop or recommend the purchase of tools that will result in leveraging information to manage analytics in order to more effectively direct resources and activities to meet risk adjustment and quality measurement objectives. In carrying out these responsibilities, The Vice President of Value-Based Care works closely with external vendors and consultants, runs outsourced health risk assessment programs, develops training programs & tools to address the educational needs of providers and non-clinical staff, assists in the development of analytic and reporting tools, and assists in the development of data collection systems and workflows to fulfill CMS and quality measurement requirements.

Benefit Highlights:

• Loan Forgiveness Program
• Challenging and rewarding work environment
• Competitive Compensation & Generous Paid Time Off
• Excellent Medical, Dental, Vision and Prescription Drug Plans
• 401(K) with company match and discounted stock plan
• SoFi Student Loan Refinancing Program
• Career development opportunities within UHS and its 300+ Subsidiaries! * More information is available on our Benefits Guest Website: benefits.uhsguest.com

About Universal Health Services:

One of the nation's largest and most respected providers of hospital and healthcare services, Universal Health Services, Inc. (UHS) has built an impressive record of achievement and performance. During the year, UHS was again recognized as one of the World's Most Admired Companies by Fortune; and listed in Forbes ranking of America's Largest Public Companies. Operating acute care hospitals, behavioral health facilities, outpatient facilities and ambulatory care access points, an insurance offering, a physician network and various related services located all over the U.S. States, Washington, D.C., Puerto Rico and the United Kingdom. www.uhs.com

Qualifications and Requirements:

• Master's Degree in Business Administration, Finance, Health Care Administration, Management or related field preferred.
• At least 5 years of health care experience working with value based Medicare Advantage STARS/HEDIS programs.
• At least 5 years of health care experience working with Medicare and/or Commercial risk adjustment programs. Requires working knowledge of CMS risk adjustment methodologies and quality improvement measures.

Skills:

• Knowledge of regulatory quality-based reporting and audit requirements;
• Proficiency in interpreting results and formulating recommendations/action plans;
• Ability to research and analyze state/federal regulations related to health insurance and healthcare;
• Demonstrated skills in critical thinking, problem-solving, and the analysis, interpretation and evaluation of complex information;
• Excellent computer skills. Microsoft Office Suite
• Personable and demonstrated ability to develop and maintain relationships at all levels.
• Well organized and demonstrate strong attention to the detail
• Ability to understand, present and analyze data.
• Strong verbal and written communication skills.
• Versatile and flexible. Inquisitive mind with strong analytical skills and the ability to do complex problem solving.
• Strong project management, meeting process and presentation skills.

EEO Statement

All UHS subsidiaries are committed to providing an environment of mutual respect where equal employment opportunities are available to all applicants and teammates. UHS subsidiaries are equal opportunity employers and as such, openly support and fully commit to recruitment, selection, placement, promotion and compensation of individuals without regard to race, color, religion, age, sex (including pregnancy, gender identity, and sexual orientation), genetic information, national origin, disability status, protected veteran status or any other characteristic protected by federal, state or local laws.

We believe that diversity and inclusion among our teammates is critical to our success.

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