Director of Value Based Care - Des Moines, IA

The Iowa Primary Care Association is hiring a Director of Value Based Care.

VISION & MISSION

The Iowa Primary Care Association’s (PCA’s) vision is Health Equity for All. Our mission is Enhancing community health centers’ capacity to care. All employees of the Iowa PCA are expected to represent the company vision and mission.

PURPOSE OF POSITION

The position will serve as the lead for the Iowa PCA’s value-based care (VBC) work by overseeing, supporting, and driving the work of our clinically integrated network, IowaHealth+ (IH+), the VBC team, initiatives, and projects, to align with the joint strategic plan, grant goals, objectives, and related outcomes. IH+ is a clinically integrated primary care network, which is a voluntary business association of primary care providers that can demonstrate financial and clinical integration. IH+ is a limited liability corporation and owned by 11 of Iowa’s community health centers and the Iowa Primary Care Association (Iowa PCA). The goal of IH+ is to develop network wide capacity to enter value-based contracts that enhance the patient experiences and engagement, improve population health outcomes, and lower health care costs.

ESSENTIAL DUTIES AND RESPONSIBILITIES

The following duties are normal for this position. These are not to be construed as exclusive or all inclusive. Other duties may be required and assigned.

• Conduct research into current and proposed value-based contracting models, understanding key performance drivers, and financial and operational feasibility of proposed terms.
• Support strategic planning for evolving value-based care work consistent with organizational priorities and monitor key performance indicators to deliver best in class programs. Partner with key organizational stakeholders to establish and integrate programs, or services necessary to successfully manage contracts with upside and/or downside risk. Translate strategy to operational tactics through focused efforts/actions that will have the greatest strategic impact, including the education of management and staff on program relevancy in the industry.
• Coordinate with the Data and Technology team to develop reporting tools to evaluate and develop actionable reports to communicate quality, risk, and cost efficiency opportunities to key stakeholders. Identify or develop care transformation solutions drawing from national best practices, analytics, personal expertise, and creativity to deliver value-based programs.
• Continually evaluate VBC team capacity and work outputs to ensure the team is appropriately resourced.
• Responsible for being a care transformation change agent through strong partnerships and collaboration with providers, clinicians and VBC stakeholders at the state and national level. Provide coaching and oversight to key team members for identified areas of operation. Align critical clinical partnerships that are necessary in such programs by creating a shared vision and fostering a relationship characterized by open communication and trust.
• Lead change initiatives both internal and external to the organization that support VBC performance.
• Coordinate appropriate training and technical assistance to health centers as requested and identified.
• Assist in preparing and presenting progress against goals monthly to boards, members, and committees, community partners, and/or health center executives as directed by the Senior Director.
• Perform other duties and projects as assigned, exhibiting willingness to adapt schedule when requested to get the job done.
• Facilitate communication across Iowa PCA teams related to identified strategies to ensure alignment of strategies, initiatives, and teams – and identify opportunities for collaboration ensuring team members are aware of deadlines, requirements and their role within the value-based program infrastructure.
• Create financial models and multi-year projections in collaboration with VBC team staff and the Finance department for value-based contracting opportunities, including analysis grounded with deep understanding and solid interpretation of the value-based payment models including CMS programs, rules and regulations.
• Identify strategic synergies between value-based contract opportunities, existing work, and established fee-for-service agreements in place at health centers. Evaluate any gaps and conflicts that may result in minimal value, upside, or opportunity.
• Develop and maintain strong relationships with Medicaid MCO partners which are productive and mutually beneficial. Includes being responsible for leading annual and long-term planning activities which identify opportunities for collaboration and alignment of priorities with MCOs and other key partners as identified.
• Be a change champion and work towards the pursuit of advancing health equity in all aspects of the work. Ensure that health equity goals are clearly translated and reinforced in day-to day work. Examples may include embedding health equity into our VBC contracts.
• Contract Management:
  • Serve as a subject matter expert to the organization on value-based economic and financial models, assessing the impact of contract terms and provisions on strategic and operational planning. Lead the preparation and review of value-based contracting opportunities for the company in collaboration with the Senior Director of Transformation and team members. Key responsibilities include:
    • Develop robust contract analytics for current risk-based arrangements to understand performance, impact of key terms within the contract on their performance, and scenario modeling of potential changes to the terms of the agreement.
    • Use a variety of data and claims files, financial statements, patient encounter data, payer contracts, value-based payment and compensation model structures to develop trend analyses, identify and quantify strategic opportunities.
    • Understand optimal value based managed care contracting, economic terms, and contract negotiation process. Coordinate strategies and tactics to ensure organizational consistency and maximize opportunities.
    • Present complex value based financial models, including CMS models, internally and with external partners to gain shared understanding of the key economic levers.
    • Develop an advanced understanding of risk adjustment in VBC contracting models for safety-net providers and continue to advance skills to optimally leverage risk adjustment into VBC contracts.

Expected Values and Behaviors:

The person in this position will be expected to model our workplace values which are:

• Collaborative – We are one team. Celebrate success together. Learn from failure together. Willing to embrace change and responsive to each other. We can and should depend on each other. Share your work and ask questions. Offer to help, offer to learn, and offer solutions to problems.
• Accountable – We work for health centers and we work with each other. Tell the truth, keep your word, listen, and make it better. Expect excellence from yourself and others.
• Respectful – Approach every interaction with thoughts of equity, inclusion, and humility. We are one organization, and we are many people. We understand our differences and are better for it. Welcome feedback of all kinds. We are all learning something.
• Deliberate – Always understand the problem before trying to solve it. Nothing should be done without a purpose. Unite around common goals, visions, and strategies.
• Proactive – We seek opportunities to learn and prepare for future challenges. Everyone is responsible, expected and empowered to prepare us for the future. Train and plan for what comes next and who comes after us.
• Transformative – We empower systems change with a lens of excellent healthcare, health equity and compassion. Or health centers lead the way; we will clear the way. Adapt to changing circumstances and improve through adversity.

SUPERVISORY RESPONSIBILITIES

This position supervises the value-based care consultants. The following leadership expectations are required:

Model the Way

• Align your words, decisions and actions with the organization’s mission, vision, and values.
• Hold yourself to a standard that is above the organization’s minimum expectations.
• When you make mistakes lead by bringing it to light, taking responsibility, and making it right.

Establish a Safe Environment

• Recognize your negative emotions and be proactive in communicating or modifying as the situation requires. Do not extend your bad day onto others.
• Express how each team member is valuable and important to the team’s and organization’s success.
• Create a team environment that supports and appreciates one another.  

Set Expectations and Hold People Accountable

• Set and clearly communicate task and behavioral expectations.
• Have the tough-love conversation with any team member who is not meeting expectations.
• Empowering team members and holding them accountable for modeling our values and for:
  • Meeting minimum behavioral and task expectations
  • Completing work tasks on time and doing quality work
  • Working well with and getting along with people
  • Finding value in others
  • Embracing change
  • Welcoming feedback and continuing to learn and grow
  • Having a point of view and speaking up respectfully
  • Listening, asking questions, and considering other points of view
  • Finding ways to continually add value to their team, the organization, and the health centers we serve

Grow People for Improved Performance

• Be faithful about having weekly 1:1’s with each member of your team.
• Use 1:1’s to build the relationship necessary to truly know one another, understand the employee’s professional goals, support the individual and address questions and concerns.
• Deliberately identify and improve the task and behavioral skill sets of your team. Every employee reporting to you should grow and be better because of your leadership.

Deliver Results

• Establish team, departmental, and/or business unit goals and a plan to meet those goals.
• Ensure the team operates efficiently and effectively to meet those goals and deliver results.

Telecommuting and Travel:

This position is required to be on-site at least two days per work week. Some travel may be required to community health centers via vehicle or conferences via air travel.

QUALIFICATIONS

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

Education and/or Experience

• A Bachelor’s in business administration, healthcare administration / management or a related healthcare field.
• A minimum of 8 years of relevant work experience demonstrating a deep understanding of, and expertise in, all value-based payment models across all lines of business including Medicaid, Medicare and commercial.
• A minimum of 5 years leading people or teams.
• Experience and proficiency with business intelligence systems for value-based care analytics.
• Strong critical thinking skills, including the ability to simplify complex strategic and financial concepts for a variety of audiences.
• Advanced leadership and communication skills to effectively operate in the complex health system environment.
• Appreciation of cultural diversity.
• Excellent facilitation and presentation skills for both clinical and non-clinical audiences, including intermediate proficiency with Microsoft PowerPoint at a minimum.
• High degree of initiative, professionalism, judgement, and discernment
• Excellent written and oral communication skills with the ability to provide clear, concise directives.

Language Skills:

Ability to read and interpret documents and operating and procedure manuals. Ability to write routine reports and correspondence. Ability to speak effectively before groups.

Mathematical Skills:

Ability to calculate figures and amounts such as discounts, interest, proportions, percentages, area, circumference, and volume. Ability to apply concepts of basic algebra and geometry.

Reasoning Ability:

Ability to solve practical problems and deal with a variety of concrete variables in situations where only limited standardization exists. Ability to interpret a variety of instructions furnished in written, oral, diagram, or schedule form.

Computer Skills:

To perform this job successfully, an individual should have knowledge of Microsoft Office programs, including spreadsheets, word processing, and databases.

Physical Demands:

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. While performing the duties of this job, the employee is regularly required to sit and talk or hear. The employee is occasionally required to sit and use hands to handle or feel. The employee must occasionally lift and/or move up to 10 pounds. Specific vision abilities required by this job include close vision.

Work Environment:

The work environment characteristics described here are representative of those an employee encounter while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. Professional business office work setting.

Iowa PCA is an Equal Opportunity Employer. In compliance with the Americans with Disabilities Act, Iowa PCA will provide reasonable accommodations to qualified individuals with disabilities and encourages prospective and existing employees to discuss potential accommodations with Iowa PCA.