Value Based Care Account Manager I/II

Job Description:

Summary:

The Value Based Care Account Manager role manages and coordinates the network partnership activities. The incumbent ensures that the Health Plan and Provider are compliant with the terms of assigned Strategic Partnership Agreements and the Accountable Cost and Quality agreements (ACQA) with varied organized health care entities.

The incumbent drives the success of the partnership and ACQA arrangements to support the Health Plan cost and quality goals. The Account Manager collaborates with Finance and Quality Health Information (QHI) in developing and producing financial and quality reporting to facilitate the success of the arrangements. This position collaborates with Product Development and Sales in the product design and development of product suites as part of strategic Provider Partnerships. This position collaborates with necessary stakeholders to ensure development and implementation of partnership initiatives as required.

This position keeps management apprised of issues and status; identifies opportunities for improvement; and acts as a catalyst for change. This position is responsible for the building and maintaining of favorable relationships with these entities; coordinating internal resources; ensuring deliverables are meaningful, timely and accurate; and issue resolution. This position is the primary liaison for assigned ACQA and/or Partnership arrangement and serves as an internal expert.

Essential Accountabilities:

Level I

• Organizes and oversees the network partnership forums including joint operations committees and quarterly meetings.
• Responsible for the day-to-day oversight of Network Partnership arrangements, including facilitating resolution of partnership issues and ensuring compliance with Network agreements.
• Acts as the internal expert and point person for information regarding the Network Partnership Value Based Care arrangements including physicians, executives and senior leadership at applicable hospital, health systems, IPAs and ACOs.
• Identifies and pursues opportunities for improvement within the arrangement. Including the coordination of internal efforts to identify opportunities and potential programs for Provider Partners to facilitate success of the ACQA; including coordination with Physician Performance Improvement, Quality Health Analytics, Finance, Actuarial, Program Management, UM/Member Care Management and Executive leadership.
• Coordinates and leads internal efforts to develop, im...

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