Sr. Manager, Value-Based Care Operations

Company Description

Privia Health™ is a technology-driven, national physician enablement company that collaborates with medical groups, health plans, and health systems to optimize physician practices, improve patient experiences, and reward doctors for delivering high-value care in both in-person and virtual settings. The Privia Platform is led by top industry talent and exceptional physician leadership, and consists of scalable operations and end-to-end, cloud-based technology that reduces unnecessary healthcare costs, achieves better outcomes, and improves the health of patients and the well-being of providers.

Job Description

The Sr. Manager, Value-Based Care Operations will be part of a team managing a diversified value based care platform with over 100+ VBC contracts and over 1 million attributed lives in commercial, Medicare (Medicare Advantage & MSSP) and Medicaid lines of business across 14 states.

The Sr. Manager, Value-Based Care Operations will be responsible for the implementation and management of existing and new value-based care arrangements and operations of initiatives related to those value based care arrangements in conjunction with payer contracting, business analytics and population health market leads. Troubleshoots issues across both Privia and payer partners across all lines of business. Serves as key communication liaison across payers and directs inquiries to the appropriate Privia health team. 

Essential Job Duties:

• Management of assigned book of business consisting of existing and new value-based care arrangements and operations of initiatives related to these value based care arrangements. Including Managing risks and developing opportunities in collaboration with local and national value based care teams.

• Create, refine and lead implementation workflows, issues/troubleshooting and value based care reporting discussions for quality, cost, and risk adjustment for value-based care contracts in both new and existing markets

• Identifying and building relationships with business owners and subject matter experts, to solve business or operational gaps with our payer partners.

• Ability to learn, understand and demonstrate analytical/quantitative thinking around the economic and clinical drivers of success in the VBC programs expressed through an understanding of the program technical designs, terms and metrics

• Develop actions plans in conjunction with internal and external stakeholders across markets driving our performance in value-based contracts

• Deliver value-based program operationalization training to internal stakeholders and external stakeholders as needed.

• Partner with cross functional and matrixed teams to drive key operational decisions, oversee implementation progress and milestones, and other project management functions.

• Develop and maintain strategic relationships with payers at a national level

• Serve as the escalation point for issues originating from the payer, market and/or Privia internal teams 

Project management support

• Develop and manage all aspects of projects including scope, requirements, project plans, risk identification and mitigation plans, communication, and issue resolution

• Develop project related deliverables with minimal supervision including project plans, PowerPoint presentations, status reports, meeting minutes, issue/risk logs, and meeting facilitation documents

• Assist with and present, as needed, presentations and updates of findings and make recommendations to internal and external stakeholders/leaders for assigned projects

• Monitor implementation and progress of various projects including, working closely with various internal PMG departments to efficiently communicate and execute on action plans and compliance-related initiatives

• Manage the coordination of various workgroups, committee meetings, and other best practice sharing events 

Qualifications

• Bachelors Degree or equivalent relevant experience 

• 5+ Years of experience

• 2+ years of experience in managed care operations, value-based care, and/or provider reimbursement and analytics

• Understanding of commercial, Medicare Advantage and Medicaid managed care preferred

• Experience with project management tools

• Handles basic issues and problems, and refers more complex issues to higher-level staff. 

• Possesses beginning to working knowledge of subject matter. 

• Must comply with all HIPAA rules and regulations

Interpersonal Skills & Attributes:

• Collaborative, customer-focused and able to create visible value

• Team approach to working with others, ability to perform a variety of duties within any work-day and organizational skills from planning to execution of tasks and projects.

• Extensive project management experience

• Process oriented with the ability to drive a project to completion

• Conflict management skills

• Problem solving skills with a proven track record

• Attention to detail

• Ability to work in a very fast-paced and changing work environment

• Ability to work independently and as a team member

• Self-directed and resourceful

• Excellent communication and client facing skills

• Excellent organizational skills

• Technical Aptitude

The salary range for this role is $95,000 to $110,000 in base pay and exclusive of any bonuses or benefits. This role is also eligible for an annual bonus targeted at 15% and restricted stock units. The base pay offered will be determined based on relevant factors such as experience, education, and geographic location.

Additional Information

All your information will be kept confidential according to EEO guidelines.

Technical Requirements (for remote workers only, not applicable for onsite/in office work):

In order to successfully work remotely, supporting our patients and providers, we require a minimum of 5 MBPS for Download Speed and 3 MBPS for the Upload Speed. This should be acquired prior to the start of your employment. The best measure of your internet speed is to use online speed tests like https://www.speedtest.net/. This gives you an update as to how fast data transfer is with your internet connection and if it meets the minimum speed requirements. Work with your internet provider if you have questions about your connection. Employees who regularly work from home offices are eligible for expense reimbursement to offset this cost.

Privia Health is committed to creating and fostering a work environment that allows and encourages you to bring your whole self to work. Privia is a better company when our people are a reflection of the communities that we serve. Our goal is to encourage people to pursue all opportunities regardless of their age, color, national origin, physical or mental (dis)ability, race, religion, gender, sex, gender identity and/or expression, marital status, veteran status, or any other characteristic protected by federal, state or local law.