Program Manager II Value Based Performance

At Cleveland Clinic Health System, we believe in a better future for healthcare. And each of us is responsible for honoring our commitment to excellence, pushing the boundaries and transforming the patient experience, every day.

We all have the power to help, heal and change lives - beginning with our own. That's the power of the Cleveland Clinic Health System team, and The Power of Every One.

Job Title
Program Manager II Value Based Performance

Location
Cleveland

Facility
Cleveland Clinic Main Campus

Department
Managed Care-Finance

Job Code
T24505

Shift
Days

Schedule
8:00am-5:00pm

Job Summary
Join the Cleveland Clinic team, where you will work alongside passionate caregivers and provide patient-first healthcare. Cleveland Clinic is recognized as the No. 4 hospital in the nation, according to the U.S. and World News Report. At Cleveland Clinic, you will work alongside passionate and dedicated caregivers, receive endless support and appreciation, and build a rewarding career with one of the most respected healthcare organizations in the world.

Join our team as a Program Manager II in Value Based Performace, where you will manage implementation, performance, and maintenance of designated value based programs. You will act as a liaison between department and internal as well as external stakeholders. As part of the CCHS Value Based team, the Project Manager will help support value based contracting, implementation, program management, and performance management for value based contracts with commercial payors. The role is key to the development and implementation of initiatives and programs to support the CCHS value based strategy. This includes performing industry and regulatory that will be used to identify, evaluate, and develop recommendations to support value based contracting, planning, and execution. This role will work 4 days a week from home and 1 day a week in the office.

Cleveland Clinic provides what matters most: career growth, delivering world-class care to our patients, continuous learning, exceptional benefits and working for an organization that offers many long-term career paths. Join us and experience a culture where opportunities to advance and the support to get there go hand-in-hand.

Job Details

Responsibilities:

• Develops, implements, manages and maintains operational systems and activities.
• Serves as a liaison with all levels of the organization and outside community.
• Manages multiple priorities and projects with competing deadlines.
• Allocates time to meet completion requirements. Serves as a coach and mentor for other positions in the department.
• Reviews and monitors adherence to Human Resources policies and corporate compliance procedures.
• Other duties as assigned.

Departmental Specific Job Responsibilities:

• Serves as a liaison with all levels of the organization and outside community.
• Drives performance on value based contracts by driving joint payer and CC initiatives.
• Develops and manages programs to ensure alternative payment contractual obligations including care delivery, quality, financial, and legal are met.
• Partners across the enterprise to implement value based contracts and drive value based contract performance with cross-functional partners including but not limited to Enterprise Analytics, Strategy, Institutes, Hospitals, and third parties.
• Reviews contract performance against expectations and help guide future alternative payment model direction to strengthen our value proposition, improve our competitive position, and meet goals and objectives.
• Works in a team environment and partner within Market Network Services with Contract Managers to incorporate alternative payment models into health plan agreements.
• Keeps up to date on industry and patient/consumer trends within the Commercial Health Plans, Employer Health, State, and Federal insurance industry.
• Supports development of strategic summaries, positioning documents, and executive presentations that clearly and professionally communicate alternative payment model strategies for senior level audiences.
• Analyzes industry trends, patient/member needs, and internal performance to deliver data-driven insights to support actionable strategic direction and prioritization.
• Manages multiple priorities and projects with competing deadlines.
• Other duties as assigned.

Education:

• Bachelor's degree in Business Administration, Healthcare Administration or related field.
• Master's degree preferred.

Certifications:

• May be required for specific positions as per policy or regulation.

Complexity of Work:

• Requires critical thinking skills, decisive judgment and the ability to work with minimal supervision. Must be able to take appropriate action in a stressful environment.

Work Experience:

• Three years of experience in systems training, project management.
• Data analysis in health care setting preferred.
• Master's Degree may substitute for one year experience.
• Demonstrated team, leadership, organizational and problem solving abilities.

Preferred Work Experience and Technical Skillset:

• MS Excel (Intermediate to Advanced User), MS Word and MS Power Point (Basic to Intermediate User)
• Healthcare experience preferred, specifically in Value Based Care
• Minimum of three years of value based contract related work experience required.
• Experience working in a health system, hospital, medical practice, or payor organizations preferred.
• Experience and working knowledge of health care business basics including, physician practice workflows, provider billing, risk coding, and payor contracting preferred.
• Experience in quality and financial performance process improvement preferred.
• An understanding of the fundamentals of patient-centered health care preferred.

Personal Protective Equipment:

• Follows Standard Precautions using personal protective equipment as required for procedures.

Keywords: Value Based Care, Value Based Contracts, Value Based Performance, Value Based Program

The policy of Cleveland Clinic Health System and its system hospitals (Cleveland Clinic Health System) is to provide equal opportunity to all of our employees and applicants for employment in our tobacco free and drug free environment. All offers of employment are followed by testing for controlled substance and nicotine. Job offers will be rescinded for candidates for employment who test positive for nicotine. Candidates for employment who are impacted by Cleveland Clinic Health System's Smoking Policy will be permitted to reapply for open positions after 90 days.

Cleveland Clinic Health System administers an influenza prevention program as well as a COVID-19 vaccine program. You will be required to comply with both programs, which will include obtaining an influenza vaccination on an annual basis, and being fully vaccinated against COVID-19, or obtaining an approved exemption.

Decisions concerning employment, transfers and promotions are made upon the basis of the best qualified candidate without regard to color, race, religion, national origin, age, sex, sexual orientation, marital status, ancestry, status as a disabled or Vietnam era veteran or any other characteristic protected by law. Information provided on this application may be shared with any Cleveland Clinic Health System facility.

Please review the Equal Employment Opportunity poster.

Cleveland Clinic Health System is pleased to be an equal employment employer: Women / Minorities / Veterans / Individuals with Disabilities