Medicaid Value Based Care Specialist
DataStaff, Inc is seeking a Medicaid Value Based Care Specialist for a long-term contract opportunity with one of our direct clients located in Raleigh, NC
*This role is hybrid; 2 days a week will be onsite
Position Description
The position supports Medicaid Managed Care priorities in the QPHE unit's work focusing on quality improvement, quality measurement and evaluation, and/or population health and practice support/provider education. This position serves in a contracted role for Quality and Population Health program management, provider training and education activities, including:
- Support the development, implementation, and management of population health initiatives focused on value-based payments (VBP) and value-based care models.
- Serve as a subject matter expert on Medicaid policies related to value-based care and payment reform initiatives.
- Coordinate the development of provider communications (presentations, newsletter, bulletins) related to VBP
- Collaborate with internal and external stakeholders to design and implement initiatives that improve health outcomes for Medicaid populations.
- Contribute to the policy, strategic planning and design of VBP products across Health Plans/LME/MCOs.
- Review VBP reports submitted by Health Plans/LME/MCOs for accuracy and completeness.
- Perform qualitative and quantitative analysis of VBP reports submitted by Health Plans/LME/MCOs.
- Monitor and evaluate program performance against defined metrics.
- Engage with stakeholders to foster strong relationships and align efforts towards commons goals.
- Support selected special projects that require cross-functional engagement with key internal and external stakeholders.
- Build effective relationships with stakeholders to include providers, vendors, beneficiaries, advocates and associations to ensure open lines of communication.
- Effectively support the communication strategy for major process changes, policy deployments or new initiatives.
- Support stakeholder education efforts to support advisory groups and community stakeholders.
- Work closely with contracted entities to ensure the quality of deliverables received
- Support with scheduling and project management
Competencies, Knowledge, Skills and Abilities Required
- Knowledge in primary care, population health models, care delivery models, care management models, and/or clinical program innovations
- Broad knowledge of Medicaid, health insurance, and health programs and policy
- Familiarity with healthcare financing mechanisms, including payment models and reimbursement structures
- Flexibility to adapt to shifting priorities and short-term deadlines
- Strong interpersonal skills, organized, and detail-oriented
- Experience researching and implementing federal and/or state laws and regulations.
- Excellent critical thinking, problem solving, project management skills.
- Ability to effectively manage day-to-day activities of complex projects
- Ability to interpret complex data, data sets and other information and to identify and communicate trends and probable outcomes
- Ability to work independently and as part of a team
- Demonstrated ability to establish and maintain strong collaborative working relationships with internal and external stakeholders.
- Demonstrated ability to communicate complex material in a clear and concise manner both verbally and in writing.
- Strong proficiency in Microsoft Office products including, Excel, Outlook, PowerPoint, and Word.
Education and Experience Required
Bachelor’s degree in a discipline directly related to the population served (social work, nursing, public administration, health administration, public health, health sciences, business administration) from an appropriately accredited institution and a minimum of two years’ experience in the creation, delivery or oversight of population health programs for the population served.
This opportunity is available as a W2 position with a competitive benefits package. DataStaff, Inc. offers medical, dental, and vision coverage options as well as paid vacation, sick, and holiday leave. As many of our opportunities are long-term, we also have a 401k program available for employees after 6 months.