Population Health Program Manager (Affiliates)

Population Health Program Manager (Affiliates)

NeueHealth is a value-driven healthcare company grounded in the belief that all health consumers are entitled to high-quality, coordinated care. By uniquely aligning the interests of health consumers, providers, and payors, we help to make healthcare accessible and affordable to all populations across the ACA Marketplace, Medicare, and Medicaid.

NeueHealth delivers clinical care to health consumers through our owned clinics Centrum Health and Premier Medical as well as unique partnerships with affiliated providers across the country. We also enable providers to succeed in performance-based arrangements through a suite of technology and services scaled centrally and deployed locally. Through our value-driven, consumer-centric approach, we are committed to transforming healthcare and creating a better care experience for all.

Job Summary

The NeueHealth Affiliates team is an integral component of NeueHealth's success as it defines and ensures value-based care delivery and performance for across NeueHealth's Affiliate portfolio, spanning FFS Medicare, ACA, Medicare Advantage, and Medicaid lines of business. As the Affiliates Population Health Program Manager, you will be responsible for the evaluation of NeueHealth's Affiliates' risk adjustment and quality program performance and the creation and delivery of education to providers and their staff. You will serve as a primary resource for Affiliate partners to educate, implement and facilitate optimization of risk adjustment and quality workflows. This role will report to the Director, Risk Adjustment and Quality at NeueHealth and cross-interface with the NeueHealth Affiliates team. The role works across departments, teams, project development offices, and lines of business to deliver best-in-class results under strict regulatory adherence and compliance mindset.

Duties & Responsibilities

• Evaluate risk adjustment and quality performance for Affiliate partners and identify opportunities and risk areas
• Cultivate effective partnerships in a matrix environment of coding educators, quality, clinical, and market operations
• Implement risk adjustment and quality program leading practices at partner practice locations
• Facilitate strategic documentation, coding and quality presentations to large and small groups of clinicians, practice managers, and certified coders via virtual and in-person delivery methods (including domestic travel when necessary)
• Develop and deliver education training materials such as webinars, videos, education guides and guidelines
• Build and maintain a best-in-class coding accuracy and HEDIS / CMS quality metric knowledgebase
• Follows, reports, and adheres to all regulatory guidance, including changes related to risk adjustment methodologies and quality programs
• Ad hoc provision of pre-visit planning support and / or engagement of other resources to deliver pre-visit planning support to Affiliates
• Other duties and responsibilities as assigned.

Education and Professional Experience

Professional Competencies

Licensures and Certifications