Manager, Value Programs

Job description

The Value Programs Manager is responsible for the strategy and operational financial management of UPG’s Value-Based Care portfolio.

This role oversees the optimization of financial and operational activities within the UPG value-based/Payment Innovation portfolio, such as contract strategy and performance, development and management of clinician/clinic/program/hospital-specific analytics to inform program monitoring and decision making, oversight of technical builds and installs to support program needs, and supervision of Practice Innovation’s P&L’s.

The Manager will be responsible for establishing comprehensive management reporting systems to demonstrate operational and financial outcomes, ensuring the transparency of Portfolio performance and financial sustainability of Practice Innovation.

In this role, the Manager will oversee relationships with government and private payers, ensuring that program management is optimized and contractual and regulatory requirements are met.

The Manager will supervise the Outreach Coordinators, directing their priorities and ensuring the quality and effectiveness of patient-facing interactions in driving program performance.

The Manager reports directly to the Chief of Practice Innovation to continue to evolve the overall value-based portfolio, and will also frequently interface with UPG, Department and System-level leadership.

**PRINCIPAL DUTIES AND RESPONSIBILITIES** **:**

+ **Financial Leadership** :
+ Lead the development and implementation of financial strategies to enhance service delivery, optimize resources, and ensure the financial health of Practice Innovation and its contributions to the greater organization.
+ Refines and maintains system for monitoring value-based revenue, in collaboration with Finance team, with detail necessary to produce analytics for optimization of program opportunities, to support methodology for funds distribution, and to inform decisions about reinvestment.
+ Develop, implement, and oversee comprehensive financial management practices, including budget preparation, expenditure monitoring, and financial reporting to ensure fiscal accountability and sustainability.

+ **Operational Efficiency** :
+ Establish and maintain systems for transparent accounting and tracking of value-based revenue, and funds flow to Departments, providers and care teams.
+ Direct program implementation work plans across projects and teams, including facilitation and management of reporting, clinical knowledge management, information systems, and clinical operations representatives.
+ Ensure program activities are coordinated, aligned, and sequenced with other organizational or strategic initiatives and/or other improvement activities.
+ Continually assess all services, identify problems, and utilize data to analyze and propose innovative approaches for solutions.

+ **Revenue Optimization** :
+ Design and manage educational programs aimed at increasing revenue through optimized medical services and enhanced patient engagement, ensuring alignment with organizational financial goals.

Evaluates strategic opportunities for revenue growth through participation in additional value-based programs and/or Fee-for-Service billing.
+ Continually assess external environment and emergence of value-based contracting activities and implications for UPG, including analyzing and preparing information to facilitate strategic and operational decision-making.
+ Direct management of the High Value Patient Outreach team, using contractual opportunities optimize and monitor performance outcomes and financial return.
+ Remain current on new payment/policy trends and best practices, resource efficiency, value-based care outcomes, population health analytics tools, etc.

and incorporate into UPG’s value-based programs.

+ **Program Management:**
+ Lead value-based care program planning, implementation, validation and monitoring.

Programs may be internally initiated or may be government, commercial, employer, or community-based.
+ Oversee interdisciplinary response to contractual expectations including representation from contracting, business, legal, quality, information systems, compliance, population health, and clinical operations.
+ Supports program evaluation and due diligence prior to deal execution and independently identifies and prioritizes necessary internal infrastructure, capabilities, and obstacles to contract performance.
+ Utilize financial and operational data analytics to monitor clinical performance, patient outcomes, and operational efficiency, ensuring continuous improvement and financial viability in service delivery.
+ Lead the development, definition, and implementation of program outcome measures along with ongoing reporting and monitoring processes to continually assess program effectiveness, monitor for areas of over and under-utilization in specific populations, and identify opportunity for program involvement.
+ Create bi-directional systems that effectively communicate information to payers and care teams.
+ Maintain accurate, complete, and current program documentation in compliance with regulatory requirements.

+ **Stakeholder Collaboration** :
+ Align payment models, payer contracting relationships, and business development with care model in collaboration with Practice Innovation Medical Director and key operational stakeholders across the organization.
+ Act as the primary liaison with administrative and professional staff, ensuring compliance with university policies, budgetary control measures, and public and private payer programs.
+ Partners across functions to ensure access to timely supplemental clinical information and technical resources for relevant contracts, including implementation of technological installations and integration of external data sources to support the work of the Practice Innovation team.
+ Communicates program goals and results, advising on areas of focus, and facilitates stakeholders to identify and implement clinical and business process changes.
+ Lead and/or serve on a variety of appropriate internal and external committees to represent UPG and facilitate the shared interests and relationship between the parties.

+ **Team Leadership** :
+ Lead, develop, and mentor a team of High Value Outreach Coordinators and Analysts, fostering a culture of continuous improvement, accountability, and professional growth.
+ Direct management of the High Value Patient Outreach team, using contractual opportunities optimize and monitor performance outcomes and financial return.
+ Create and maintain a satisfying workplace that fosters professional growth and job satisfaction for all members of the healthcare team.

+ Other duties, as assigned.

**REQUIRED QUALIFICATIONS (Knowledge, Skills & Abilities)** **:**

**Education:** Bachelor’s degree in Healthcare Administration, Public Health, Social Work, Business Administration, Economics, Industrial Engineering, or related field.

Master’s degree preferred.

**Level and type of experience REQUIRED:**

+ 10+ years of experience in a healthcare setting
+ Project or program management experience, including program/project development, implementation, and monitoring.
+ Advanced knowledge of value-based care reimbursement models and pay-for performance programs in the commercial and governmental sectors, particularly Medicare value-based purchasing and alternative payment models.
+ Experience in collaborating to develop, implement, and evaluate population health programs with positive clinical and financial outcomes within program guidelines and resource allocations.
+ Successful track record of building operational processes and workflows in support of value-based care contract outcomes delivery .
+ Experience working with technical teams to collaborate on scalable solutions to support business objectives.

Preferred Experience:

+ Experience working in an academic health system or integrated healthcare delivery system
+ Regulatory and/or contractual requirement management experience
+ Knowledge of population health policy, reporting requirements and alternative payment trends

**Skills:**

+ Excellent written and oral communication skills, including an ability to explain observations and findings to diverse stakeholder audiences.
+ Articulates and presents data, information, and ideas in a clear and concise manner.
+ Proven ability to independently organize and prioritize projects, efforts and workloads based upon the needs of the organization within a rapidly expanding environment.
+ Demonstrated ability to form strong working relationships, and be highly collaborative across multiple internal and external stakeholders.
+ Influential leader of change, creates compulsory enthusiasm to leadership regarding broader needs of the organization.
+ Strong analytical and critical thinking skills, including comfort with analyses to support data-driven recommendations.
+ Demonstrated ability to lead activities, manage tasks, and coordinate the work of multidisciplinary teams to deliver high quality work on time.
+ Strong track record of problem and issue resolution.
+ A high degree of professionalism and competency in dealing with a variety of individuals.
+ Ability to identify data needed for both assessment and decision-making purposes.
+ Ability to deploy appropriate data sources, analysis methods, and effective communication of analytical results.

This is primarily a sedentary job involving extensive use of desktop computers.

The job does occasionally require regional travel.

**SUPERVISORY RESPONSIBILITIES** **:** The incumbent directly manages a team including Outreach Coordinators, Business Analysts and Quality Reporting Analysts.

Incumbent may manage and implement projects across operating units, collaborating with clinical departments, practices and administrative staff, as well as external stakeholders.

_The_ _University of Virginia is an equal opportunity employer.

All interested persons are encouraged to apply, including veterans and individuals with disabilities.

Click_ here (https://eocr.virginia.edu/notice-non-discrimination-and-equal-opportunity) _to read more about UVA’s commitment to non-discrimination and equal opportunity employment._

Required Skill Profession

Other General