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CareSourceCA

Health Partner Incentive Manager

CareSource is a nonprofit managed care organization based in Dayton, Ohio, that serves over 2 million members with a wide array of Medicaid and Medicare products.

CareSource

Employee count: 1001-5000

Salary: 71k-113k USD

United States only

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Job Summary:

The Health Partner Incentive Manager is responsible for managing value-based reimbursement programs within an assigned market or product. The Health Partner Incentive Manager will manage internal and external stakeholder priorities to ensure customized performance plans address the strategy and goals in a highly matrixed organization which will translate to increased Provider performance and efficiencies.

Essential Functions:

  • Ensure accurate and timely implementation of new Value Based health partner contracts for assigned market
  • Review Alternative Payment Modelt (APM) reports to validate accuracy and distribute scorecards to providers as appropriate
  • Oversee multidisciplinary implementation of complex reimbursement relationships within the assigned market
  • Model provider performance in proposed or current APM programs to show opportunity or value of program
  • Responsible for the development of customized provider performance plans to support quality improvement activity and APM goals for key areas across the organization
  • Monitor and asses customized plans to identify any necessary changes or enhancements to quality or financial goals
  • Participate in identifying and implementing performance improvement initiatives to improve process of implementation of new health partner contracts and maintenance
  • Oversee and coordinate systematic population management initiatives
  • Work with internal stakeholders and leadership to coordinate development of APM programs
  • Provide insight and analysis to assist leadership in targeting providers for APM programs
  • Develop enhanced APM Program reporting for assigned market
  • Continually develop and enhance training and literature for internal and external users
  • Participate in key committees, subcommittees, and work groups as necessary
  • Develop and report on key accomplishments and issues to leadership
  • Meet with Providers, as needed, and answer any related questions
  • Manage multiple projects, collect and analyze data and disseminate to appropriate departments as necessary
  • Perform any other job duties as requested

Education and Experience:

  • Bachelor’s Degree in Business Administration, or related field or equivalent work experience is preferred
  • Minimum of three (3) years of experience in data analysis, reporting, or data support is required
  • Previous experience in healthcare, preferably in managed health plan industry is preferred
  • Experience in quality improvement is preferred

Competencies, Knowledge and Skills:

  • Proficient with Microsoft Office to include Word, Excel and PowerPoint
  • Quality improvement process and analysis skills
  • Excellent written and verbal communications skills
  • Demonstrated ability in identifying problems, developing solutions and implementing effective courses of action.
  • Ability to develop, prioritize and accomplish goals
  • Ability to work on multiple projects
  • Strong interpersonal skills and high level of professionalism
  • Effective listening and critical thinking skills
  • Effective problem-solving skills with attention to detail
  • Ability to work independently and within a team
  • Excellent leadership skills
  • Ability to create and maintain excellent working relationships

Licensure and Certification:

  • None

Working Conditions:

  • General office environment; may be required to sit or stand for extended periods of time
  • May be required to travel occasionally

Compensation Range:

$70,800.00 - $113,200.00

CareSource takes into consideration a combination of a candidate’s education, training, and experience as well as the position’s scope and complexity, the discretion and latitude required for the role, and other external and internal data when establishing a salary level. In addition to base compensation, you may qualify for a bonus tied to company and individual performance. We are highly invested in every employee’s total well-being and offer a substantial and comprehensive total rewards package.

Compensation Type (hourly/salary):

Salary

Organization Level Competencies

  • Fostering a Collaborative Workplace Culture

  • Cultivate Partnerships

  • Develop Self and Others

  • Drive Execution

  • Influence Others

  • Pursue Personal Excellence

  • Understand the Business

This job description is not all inclusive. CareSource reserves the right to amend this job description at any time. CareSource is an Equal Opportunity Employer. We are dedicated to fostering an environment of belonging that welcomes and supports individuals of all backgrounds.

About the job

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Posted on

Job type

Full Time

Experience level

Manager

Salary

Salary: 71k-113k USD

Location requirements

Hiring timezones

United States +/- 0 hours

About CareSource

Learn more about CareSource and their company culture.

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CareSource is a nonprofit, nationally recognized managed care organization established in 1989 that has grown to serve over 2.1 million members across various states in the U.S. With its headquarters in Dayton, Ohio, CareSource administers one of the largest Medicaid managed care plans in the country. The organization offers a wide range of health insurance products, including Medicaid, Medicare Advantage, and Health Insurance Marketplace plans. CareSource stands apart by addressing the social determinants of health which significantly impact the well-being and health outcomes of its members. This mission-driven approach enables them to provide personalized care solutions that cater to the unique needs of low-income and vulnerable populations.

As part of its commitment to innovative care delivery, CareSource continually enhances its services through technology and partnerships designed to streamline access to care and improve member experiences. The organization employs nearly 5,000 individuals who are dedicated to fostering community relationships and ensuring that every member receives high-quality care when needed. Their strategic initiatives focus on improving health outcomes, operational excellence, and social equity within the healthcare realm. In addition to traditional medical services, CareSource actively engages in health education and outreach efforts that foster resilience and self-sufficiency in the communities they serve. This approach contributes to a broader aim of not just treating illness but promoting overall health and wellness in society.

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CareSource

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