Job Description

Silver Cross Hospital is an extraordinary place to work. We’re known for our culture of excellence and delivery of unrivaled experiences for our patients, their families, the communities we serve…and for each other. Come join us! It’s the way you want to be treated.

Responsible for analyzing and evaluating all data that is used for Silver Cross Health Connection including but not limited to Medicare Advanced Payment Model, Blue Cross Blue Shield ACO, Medicare Advantage Plans, and any other Managed Care/Value Based Plans. This position will also be responsible for reporting, quality assurance, and putting together presentations to pertinent groups that are involved with Silver Cross Health Connection.

Essential Duties and Responsibilities:

• Develop and expand data reporting library for PHO
• Meet with Practices and Physicians
• Presentations: presenting findings from financial reports that are created
• Evaluate/Understand Value Based Care and various contracting structures that may exist and recommend what would be best for the PHO
• Data mine to identify areas of opportunity for the PHO
• Support critical Board, Committees, Utilization Management, Finance, and Quality decisions that the PHO need to make.
• Implement innovations governmental programs (Medicare, Medicaid, and exchanges) and identify opportunities to pursue innovative ideas.
• Develop strategy for utilization management, quality, and risk coding program based on report findings.
• Identify ways to offer gain sharing opportunities to network physicians and steps to implement programs.
• Position Silver Cross Hospital and Silver Cross PHO as a top Performer and gain access to “first to market opportunities.
• Create service area reports that help Admin Director of Value Based Care create overall strategy for network development.
• Evaluate opportunities and make recommendations to physicians and senior management
• Integrate pricing, contracting and program development strategies to maximize volume and profitability.
• Review contracts annually, for PHO, and align strategies to ensure profitability and bonus potential for physicians.
• Employee decision support tools to model and identify opportunities to negotiate improved quality gap closure and risk scoring optimization.

Required Qualifications

Education and Training

• 5-9 years’ experience in healthcare at commercial payors, hospitals or consulting firms
• Bachelor’s degree required
• Significant experience contracting and population health programs
• Experience with Medicare Advantage
• Ability to communicate complex issues/analysis to providers to effectuate change
• Ability to work effectively with physician organizations.
• Working with physician organizations.
• Ability to analyze and synthesize large amounts of quantitative and qualitative data.
• Demonstrate a high level of proficiency using database applications.

Work Shift Details:

Days - First Shift, Full-time

Department:

BUSINESS INTELLIGENCE

Benefits for You

At Silver Cross Hospital, we care about your health and well-being and that is why we work hard to provide quality and affordable benefit options for you and your eligible family members.

Silver Cross Hospital and Silver Cross Medical Groups offer a comprehensive benefit package available for Full-time and Part-time employees which includes:

· Medical, Dental and Vision plans

· Life Insurance

· Flexible Spending Account

· Other voluntary benefit plans

· PTO and Sick time

· 401(k) plan with a match

· Wellness program

· Tuition Reimbursement

Registry employees who meet eligibility may participate in our 401(k) Savings plan with a potential match. However,registry employees are ineligible for Health and Welfare benefits.

The final pay rate offered may be more than the posted range based on several factors including but not limited to: licensure, certifications, work experience, education, knowledge, demonstrated abilities, internal equity, market data, and more.

The expected pay for this position is listed below:

$35.76 - $45.60