• Senior Medicare Program Analyst

    Job Locations US-NJ-Marlton
    Posted Date 2 months ago(4/3/2018 2:37 PM)
    Job ID
    2018-1100
    # of Openings
    1
    Category
    Revenue Cycle Management
  • Overview

    As a management services organization (MSO), Continuum Health delivers proven solutions to provider groups and aggregators, helping foster self-sufficiency by maximizing fee-for-service payments, transitioning them to value-based programs and preparing them for risk. Continuum also collaborates with payers to help drive value-based adoption among providers and improve the health outcomes of patients. The company optimizes performance through revenue cycle management, value-based care, practice management services and specialty care solutions. More than 1,500 primary care physicians, specialists and nurse practitioners caring for more than 1 million patients depend on Continuum’s business and clinical experts to help achieve their goals. Learn more at www.continuumhealth.net.

    Responsibilities

    POSITION PURPOSE:

     

    The Senior Medicare Program Analyst integrates Medicare and Medicare Advantage alternative payment model knowledge with practical program management experience.  S/he facilitates the documentation, communication and execution or Medicare alternative payment model programs across internal and external customers. The successful candidate will demonstrate success enhancing Continuum Health’s people, process and technology in support of successful program execution across a range of value-based programs.

     

    The Senior Medicare Program Analyst improves the ability of our organization to support physicians in various practice models including single tax ID number practices, independent physician associations and employed physician arrangements.  In addition, the successful candidate will understand and be able to communicate the specific requirements or various Medicare and Medicare Advantage alternative payment models including MACRA/MIPS, STARs and Risk Adjustment.

     

    The Senior Medicare Program Analyst will support the Vice President of Integrated Care/Payor Strategy in maximizing revenue from various commercial, Medicare Advantage and Medicaid health plan contracts through the successful execution of contractual quality incentives.

     

     

    ESSENTIAL FUNCTIONS:

     

    • Maintains knowledge of commercial and governmental quality programs to include, but not limited to: PCMH, Meaningful Use, MACRA, MIPS, STARs and Risk Adjustment.
    • Demonstrates project management skills including but not limited to scoping, planning, implementing and tracking program performance utilizing established tools
    • Monitors, analyzes, and reports on the adherence of all quality and performance metrics for Continuum Health’s health plan clients.
    • Analyzes multiple approaches/solutions to any performance deficiencies.
    • Maintains knowledge and competency that reflects current quality programs and other healthcare cost of care strategies.
    • Collaborates with other Continuum Health Alliance departments to ensure the triple aim of improved quality, improved patient satisfaction and engagement, and reduced overall healthcare spend is achieved for all clients.
    • Participates in inter and intra departmental meetings as necessary.
    • Considers factors related to effectiveness, costs, and impact in conducting program management.
    • Employs effective communications to all clients.
    • Other duties as assigned.

     

    COMPETENCIES:

     

    • Core
      • Customer Focused
      • Developing Others
      • Interdependence (Team Focused)
      • Mission Centered
      • Open Communication

     

    • Project Leader
      • Organizational Knowledge
      • Project Methodology
      • Project Team Building
      • Results Oriented

     

    • Service Delivery Leader
      • Building Relationships
      • Industry Expertise
      • Planning & Prioritizing
      • Problem Solving
      • Supporting & Implementing Change

     

    • Systems and Integration Leader
      • Analytic Decision Making
      • Industry and Regulatory Knowledge
      • Managing Projects
      • Systems Thinking
      • Decision-Making Support
      • Active Listening/Strong Communicator
      • Motivated Team Player

     

     

    WORKING CONDITIONS AND PHYSICAL DEMANDS:

     

    1. Requires the ability to frequently respond to multiple demands and priorities.
    2. Travel to client sites required.

    Qualifications

    MINIMUM EDUCATION, LICENSURE, CERTIFICATION, AND EXPERIENCE REQUIRED:

     

    The Senior Medicare Program Analyst must hold a bachelor’s degree. A master’s degree in healthcare or business information is preferred.

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