Your opportunity 

As the Manager, Payer Performance Quality, you play a crucial role in supporting the quality strategy to achieve Vytalize Health’s performance goals in value-based care / private payer contracts. You will contribute to the development of quality strategic plans, execute those plans, monitor quality performance, and conduct the daily operational work needed to support these contracts. 

What You Will Do 

• Build and own payer relationships
• Act as the Subject Matter Expert in Medicare Advantage, Commercial and Medicaid space
• Conduct the daily work needed to support gap in care closure
• Contribute to the creation of short and long-term strategic plans to achieve quality performance goals
• Identify quality measures in need of improvement and propose interventions – balancing creative thinking with available resources and realistic objectives
• Break down performance goals into actionable steps and processes, and see through to execution/completion
• Collaborate with both internal teams and external payer partners to improve quality performance and increase gap closure rates
• Set direction on gap in care worklists for internal and external teams; track progress of worklist completion and outcomes
• Conduct chart reviews and audits via remote EMR access
• Use Vytalize Health tools and raw payer data (performance reports and gap in care files)
• Assist with the creation of educational/informational material related to quality 
• Balance multiple, competing priorities with ability to prioritize and pivot based on feedback and information available
• In depth understanding of contract requirements related to quality measure specifications, targets, and deadlines
• Ensure compliance with NCQA, HEDIS, CMS and other regulations supporting quality in VBC contracts
• Stay updated of industry trends, regulatory changes, and best practices in quality performance

Requirements

• Bachelor’s degree in healthcare management, business administration, or a related field.
• 5+ years of experience in value-based care, quality performance improvement, or population health management within the healthcare industry (physician office, health system, and/or insurance company).
• Prior experience supporting Commercial and Medicaid VBC contracts.
• Strong data manipulation and analytics skills with Excel or similar.
• Operational excellence/practice transformation experience.
• Track record of building solutions.
• Ability to work on multiple concurrent projects.
• Ability to work successfully in a dynamic startup environment.
• Proven track record of successful management in value-based care contracts
• In-depth understanding of quality performance in value-based care contracts
• Strong problem-solving skills with the ability to define and execute on strategies to improve quality performance 
• Detail oriented and skilled with ensuring all deliverables are accurate, thorough, and well composed 
• Effective communication skills – verbal and written
• Ability to operate independently as well as part of a team
• Extensive knowledge of HEDIS and CMS quality measure specifications
• Ability to adapt to a dynamic and changing healthcare landscape
• The role requires a proactive and strategic mindset, with a focus on continuous improvement
• Occasional travel may be required to meet with payers, providers, or attend industry events
• Commitment to maintaining confidentiality and acting with integrity in all interactions
• Relevant certifications in healthcare management or quality are a plus

Perks/Benefits

• Competitive base compensation
• Annual bonus potential
• Health benefits effective on start date; 100% coverage for base plan, up to 90% coverage on all other plans for individuals and families 
• Health & Wellness Program; up to $300 per quarter for your overall well-being available on start date 
• 401K plan effective on the first of the month after your start date; 100% of up to 4% of your annual salary
• 5 sick days and unlimited (or generous) paid "Vytal Time" after your first 90 days
• Company paid STD/LTD
• Technology setup 
• Ability to help build a market leader in value-based healthcare at a rapidly growing organization

Please note at no time during our screening, interview, or selection process do we ask for additional personal information (beyond your resume) or account/financial information.  We will also never ask for you to purchase anything; nor will we every interview you via text message. Any communication received from a Vytalize Health recruiter during your screening, interviewing, or selection process will come from an email ending in @vytalizehealth.com.