Executive Director, Value Based Performance at Wellstar Health Systems in Marietta, Georgia

Job Description:

Facility: WCO - Wellstar Corporate Office



Job Summary:



The purpose of the Executive Director, Value Based Performance position is to provide the leadership that will drive optimal performance in quality metrics for Wellstar Clinical Partners' Accountable Care Organization. This leader will be responsible for developing strategies and initiatives and leading a team of Population Health Clinical Coordinators and Quality Coordinators to achieve top percentile outcomes across all WCP value-based contracts. This position will have significant responsibility for ensuring that not only do we meet quality requirements and expectations for our growing list of value-based contracts, but this person will be responsible for ensuring that we are able to return the highest level of potential financial incentives for meeting quality goals for each contract. The potential reward dollars total in the millions. The level of knowledge required is complex in regard to understanding HEDIS metrics, CMS quality metrics and compliance.
The number of positions that this person will manage will grow as we add additional contracts. This person will also require the executive presence to interact with multiple stakeholders and leaders across almost all multiple service lines. They will need a strategic mindset to constantly plan initiatives to achieve the highest quality goals. This person will serve as a Dyad Partner to the Executive Director Managed Care to provide feedback and ensure successful achievement of required metrics to achieve optimal shared savings.




Core Responsibilities and Essential Functions:



Reporting to the AVP for Population Health Management, the Exec Director for Value Based Performance will develop and operationalize best practices to achieve consistent value-based outcomes.
Serve as the subject matter expert in CMS ACO Quality metrics.
Oversee accurate and timely reporting of CMS metrics.
Serve as Liaison between Population Health, Wellstar Clinical Partners, and Payers with whom we have value-based contracts.
Partner with Executive Director of Managed Care Contracting to stay informed on current and future value-based contracts, with emphasis on
performance-related metrics.
Lead and facilitate Payer Joint Operating Committees.
Organize and facilitate Optimization work groups for contracts where there are opportunities for improving outcomes.
Working with the Director for Population Health Strategy, utilize data and analytics to monitor and report on contract performance.
Partner with WCP Operations team to provide committees with timely updates on contract performance related to defined quality metrics.
Identify and prioritize opportunities for improved performance.
Leadership and Oversight of WCPs Quality Coordinators and Population Health Clinical Coordinators. Will have Direct Leadership over the Director Clinical Integration and the Manager for Quality Coordinators. Will have a Matrix relationship with the Director of Medicare Ambulatory Care Management, and Medical Director Population Health.
Effectively manage team members and resources within the Population Health department, as assigned to this role.
Develop standard work and processes for Population Health Clinical Coordinators and WCP Quality Coordinators.
Responsible for recruiting, interviewing, and onboarding qualified candidates for the role of Population Health Clinical Coordinator and other related roles as assigned.
Provide ongoing education, coaching and oversight to Population Health Clinical Coordinators and feedback to the WCP Quality Coordinators.
Share performance opportunities and define practice communication priorities for the WCP Quality Coordinators to communicate to practices.
Additional Key Responsibilities:
Lead Joint Operating Committees for Value Based Contract Performance.
Partners with service line leaders to communicate performance opportunities and to participate in developing best practices to achieving optimal outcomes.
Share Payer information with appropriate Service Line Leaders.
Stay abreast of CMS guidelines and directives related to quality reporting.
Prepares presentations and proposals, presenting in formal meetings to senior leadership and Board members as needed.
Participate in System Committees as aligned with Population Health strategy and having potential impact on value-based performance.
Performs other duties as assigned
Complies with all Wellstar Health System policies, standards of work, and code of conduct.




Required Minimum Education:

• Masters Nursing or Masters Health Science or Masters Public Health or Masters Health Administration or Masters Social Work

Required Minimum License(s) and Certification(s):



All certifications are required upon hire unless otherwise stated.

• RN - Multi-state Compact-Preferred or Master Social Worker-Preferred


• Accredited Case Manager-Preferred

Additional License(s) and Certification(s):





Required Minimum Experience:



Minimum 10 years Health Care Experience required. Prefer experience with Accountable Care Organizations, Quality Reporting, Value-Based Care, or Population Health. Required




Required Minimum Skills:



Ability to establish partnerships, build consensus, motivate action and manage change to further the Quality strategic plan High
Ability to engage and influence leaders at all levels, regardless of reporting relationships High
Effective, fair and just management of people High
Exceptional critical thinking, data analysis and problem-solving skills High
Highly organized with a structured approach to task and information management Medium
Expert skills in performance improvement including but not limited to Lean, PDSA, etc. High
Exceptional verbal and written communication skills with strong situational awareness and business acumen High
Commitment to personal and professional growth Medium
Sense of responsibility to self, team, and project High
Initiative, creativity, and passion Medium
Ability to work in an ambiguous environment High
Ability to work cohesively with Information Technology counterparts Medium
Expert competence in applications such as Microsoft Office Suite, Microsoft 365, Project Managment tools, EPIC, etc. High Apply Now