Description

AdventHealth Corporate

All the benefits and perks you need for you and your family:

· Benefits from Day One

· Career Development

· Whole Person Wellbeing Resources

· Mental Health Resources and Support

Our promise to you:

Joining AdventHealth is about being part of something bigger. It’s about belonging to a community that believes in the wholeness of each person, and serves to uplift others in body, mind and spirit. AdventHealth is a place where you can thrive professionally, and grow spiritually, by Extending the Healing Ministry of Christ. Where you will be valued for who you are and the unique experiences you bring to our purpose-minded team. All while understanding that together we are even better.

Shift : Monday-Friday

Job Location : Remote; Need to be able to go onsite for training, if needed

The role you’ll contribute:

The purpose of this position is to provide Population Health subject matter expertise, consultation, and education to network providers (market/region dependent) by establishing and maintaining a strong relationship with the provider and practice. Population Management Advisors are expected to make regular visits to provider practice offices, with the intent to advise and educate on a wide variety of topics Examples include population health management strategies and programs, clinical integration, incentive program(s), provider web portals, quality care gap closure efforts, if applicable, and PHSO or Regional Market CIN and provider network policies and procedures.

The Population Management Advisor (PMA) is designed to provide value to the network provider and practice through expertise, consultation, change management, and provider engagement. The Population Management Advisor is the relationship manager for the practice and exists to help simplify the provider’s experience with the PHSO, Regional Market CIN, and/or affiliated payer networks/health plans while working to identify and address improvement opportunities. The PMA will be responsible for executing plans as it relates to value-based performance including quality, cost, and patient experience opportunities, and delivering key messages to providers and office staff. This position is remote with most time spent contacting provider offices.

The value you’ll bring to the team:

PRINCIPAL DUTIES AND JOB RESPONSIBILITIES:

1. Uses knowledge to help connect key concepts and expectations, ultimately presenting the PHSO, Regional Market CIN, and/or affiliated payer networks/health plans, in a manner that is simple for providers to relate to. Regular rounding to communicate messages about the value of solutions, strategies, performance/incentive models, policies, procedures and to timely issue resolution.

2. On boarding providers for Provider Networks and affiliated payer networks/health plans to ensure provider is informed and engaged related to essential information.

3. Facilitates practice change management regarding emerging trends related to population health initiatives, reimbursement models, patient satisfaction, customer outreach, panel growth, and provider performance with quality and efficiency metrics. The Advisor should be seen as an asset to their practices by collaborating with other PHSO teams to facilitate the provider/practice with closing care gaps and other population management performance to help ensure success in the value-based healthcare environment.

4. Actively participates in continuing education topics for other Population Management Advisors. Suggests topics or items based on conversations occurring in the field or based on other perceived gaps in education.

5. Responsible for tracking, measuring, analyzing, and reporting on provider contacts, updating provider demographics, validating provider contact information, and reporting issues in the designated provider reporting tool.

6. Fully understands the provider and ancillary makeup of the provider network, and affiliated payer networks in order to provide relevant feedback and intel related to potential needs.

7. Responsible for maintaining and understanding assigned territories including market attributes, providers in the community, and other pertinent information.

8. Works seamlessly, effectively, and in harmony with all internal teams including, but not limited to, PHSO, Regional Market CIN, and/or affiliated payer networks/health plans credentialing, provider resolution center, quality and care integration, provider engagement education, and analytics to ensure integrated operations that result in a superior consumer experience for the provider.

9. Responsible for maintaining operational knowledge of Epic Healthy Planet Link or any similar business intelligence tools and assisting providers with understanding and utilization of such tools and engaging other PHSO, Regional Market CIN, and/or affiliated payer networks/health plans resources/teams as needed.

Qualifications

The expertise and experiences you’ll need to succeed:

KNOWLEDGE AND SKILLS REQUIRED:

· Demonstrated excellent relationship management skills.

· Demonstrated excellent negotiation skills.

· Knowledge of health plan/claims-related processes (Clinical Procedural (CPT) coding knowledge a plus)

· Strong project management & strategic thinking skills

· Strong organizational skills

· Knowledge of hospital and provider (multi-specialty group, IPA or PHO) operations and services impacted by managed care and health care reform.

· Knowledge about both the clinical and financial aspects of managed care, including capitation and global budgets.

· Demonstrated basic knowledge of processes within the ambulatory practice/provider setting.

· Demonstrated experience in preparing and delivering written and oral reports.

· Strong skills for using various information systems tools to identify performance improvement opportunities, communicate these opportunities to providers and track improvements.

· Ability to handle difficult and complicated situations and maintain professionalism.

· An understanding of health plan operations and network quality and efficiency initiatives related to providers, including reporting and attestation of quality measures.

KNOWLEDGE AND SKILLS PREFERRED:

· Knowledge of Population Health initiatives and the triple-aim - to include value-based performance incentives for providers

· Knowledge of performance metrics (quality and efficiency measures)

· Knowledge of CMS’ Risk Adjustment model

· Electronic Health Record experience (Epic, Athena, eClinicalWorks, Cerner, etc…)

EDUCATION AND EXPERIENCE REQUIRED :

· Bachelor’s Degree in healthcare, business or a related field; or 6+ years of related experience.

· 3+ years’ experience in performance improvement, operations, marketing or in a relevant physician/ hospital/ managed care environment.

· 3+ years’ experience working collegially with physicians.

EDUCATION AND EXPERIENCE PREFERRED:

· Master’s Degree in healthcare, business or a related field

· 7+ years’ experience in performance improvement, operations, marketing or in a relevant physician / hospital / managed care environment.

· 7+ years’ experience working collegially with physicians

This facility is an equal opportunity employer and complies with federal, state and local anti-discrimination laws, regulations and ordinances.

Category: Population Health

Organization: AdventHealth Corporate

Schedule: Full-time

Shift: 1 - Day

Req ID: 23033455

We are an equal opportunity employer and do not tolerate discrimination based on race, color, creed, religion, national origin, sex, marital status, age or disability/handicap with respect to recruitment, selection, placement, promotion, wages, benefits and other terms and conditions of employment.