Director of Growth and Provider Initiatives
Amida Care identifies key providers as those whose partnership is essential to growth and the transition to value-based contracting and quality improvement. This position is responsible for enhanced sponsor/key provider relations, value based and quality incentives pilot arrangements and major growth partnerships. This role leads the development of quality incentive and value-based contracting metrics, provider reporting and engagement, and supports providers in achieving quality incentive objectives.
Essential functions are job duties and responsibilities that must be performed to accomplish the purpose/ goals of the job.
• Elevate and continuously enhance Amida Care’s relationship with key provider partners as described above. Plan and manage individualized partner growth plans. Support growth plans through planning and developing growth-focused initiatives in collaboration with each key provider partners.
• Own and drive execution and follow-through on internal operational activities related to sponsors/key providers, as described above, growth initiatives and programs. Ensure Amida Care commitments are met and coordinate Amida Care contact with sponsors/key providers so as to reinforce the partnership.
• Develop, cultivate and manage new relationships with sponsors and key provider partners, as described above that are critical to growth. Rebuild/reestablish strong relationships with existing partners where disjointed interaction with Amida Care may have strained relations.
• Identify requirements for selecting value-based partners and manage day-to-day oversight of quality incentive programs.
• Lead, manage and retain/hire quality staff and the on-going planning, monitoring, training, coaching, evaluation, and appraisal of staff performance and development to ensure successful achievement of goals and objectives.
• Facilitate with senior management the development and execution of contract amendments related to quality incentive programs, shared savings and risk.
• Develop and oversee reporting requirements and run daily, weekly, and/or monthly reports as needed to share with sponsors/key provider groups. Present results to value-based partners and ensure positive relations with value-based Partners.
• Maintain value-based contracts with Federally Qualified Health Centers (FQHCs)/Community Health Centers, Independent Practice Associations (IPAs), large medical groups and hospital-based Faculty Practice Plans (FPPs) on behalf of Amida Care.
• Utilize in-depth knowledge of Medicaid reimbursement methodologies, fee schedule models, financial models and analysis in development of programs that provide value and quality based metrics.
• Bachelor’s Degree in health care administration or business; or equivalent combination of education and relevant work experience.
• Minimum of five (5) years’ experience in health care; including at least four (4) years in provider/payor contracting with focus on value-based contracting.
• Demonstrated experience in designing and running reports, and managing data bases to support quality metrics.
• Strong knowledge of medical terminology for quality incentive programs.
• Demonstrated experience in developing and recommending potential solutions to contract, claims and provider service issues.
• Demonstrated superior interpersonal relationship skills including evidence of same.
• Strong knowledge of Microsoft Office (Word, Excel, Access, PowerPoint).
• Demonstrate understanding and sensitivity to multi-cultural values, beliefs, and attitudes of both internal and external contacts.
• Demonstrate appropriate behaviors in accordance with the organization’s vision, mission, and values.