Job description

Apply on line at http://www.alohacare.org/Careers/Default.aspx

The Company:

AlohaCare is a local, non-profit health plan serving the Medicaid and Medicare dual eligible population. We provide comprehensive managed care to qualifying health plan members through well-established partnerships with quality health care providers and community-governed health centers. Our mission is to serve individuals and communities in the true spirit of aloha by ensuring and advocating access to quality health care for all. This is accomplished with emphasis on prevention and primary care through community health centers that founded us and continue to guide us as well as with others that share our commitment. As Hawaii’s third-largest health plan, AlohaCare offers comprehensive prevention, primary and specialty care coverage in order to successfully build a healthy Hawaii.

The Culture:

AlohaCare employees share a passion for helping Hawaii’s most underserved communities. This passion for helping and caring for others is internalized and applied to our employees through a supportive and positive work environment, healthy work/life balance, continuous communication, and a generous benefits package.

AlohaCare’s leadership empowers and engages its employees through frequent diversity, recognition, community, and educational events and programs. AlohaCare has a strong commitment to support Hawaii’s families and reinforces a healthy work/home balance for its employees. Because AlohaCare values honesty, respect, and trust with both our internal and external customers, we encourage open-door, two-way communication through daily interactions, employee events and quarterly all-staff meetings. AlohaCare’s comprehensive benefits package includes low cost medical, dental, drug and vision insurance, PTO program, 401k employer contribution, referral bonus and pretax transportation and parking program.

These employee-focused efforts contribute to a friendly, team-oriented culture which is positively reflected in the communities we serve.

Position Summary of a Value Based Program (VBP) Coordinator :

The Value Based Program (VBP) Coordinator serves as a primary liaison for value-based purchasing (VBP) arrangements with responsibilities that include provider retention, recruitment, and educational activities to support AlohaCare’s VBP program and related goals. Represent AlohaCare in a highly professional manner consistent with organizational values and branding objectives. Participate in on-going identification and adaptation of processes and practices to meet AlohaCare’s provider-incentive and VBP objectives.

Primary Responsibilities of a Value Based Program (VBP) Coordinator:

· Develop and maintain plans to meet AlohaCare’s Value Based Purchasing (VBP) initiatives in line with regulatory requirements.

· Conduct outreach to providers to expand the number of providers under VBP arrangements.

· Serve as the main point of contact for VBP entities. Identify and assist in the resolution of barriers to VBP contracting with priority providers.

· Develop and maintain processes for tracking and reporting performance metrics that align with VBP deliverables such as performance metrics; receipt, tracking and routing of files from VBP entities that are used for payment and reporting purposes (such as monthly provider rosters, lists of individuals in patient programs, VBP entity attribution processes); and other data exchanges.

· Provide monthly member attribution reports, other reports, and feedback to VBP entities.

· Partner with AlohaCare’s Quality Improvement staff to ensure regular updates and status on VBP entity performance measures are regularly discussed with VBP entities, and VBP objectives continue to support AlohaCare’s quality improvement initiatives.

· Provide analytical assistance to determine the number of members needed to meet performance measure targets.

· Help facilitate and attend joint operations committee meetings with VBP entities and develop VBP related meeting materials.

· Facilitate the development of member/patient outreach mechanisms (e.g., text messaging) to support VBP entities to increase patient engagement/attribution.

· Discuss and coordinate primary care provider (PCP) re-assignments with Customer Service leadership to reduce volume of members who are not assigned to the correct PCP.

· Facilitate support from Health Services staff to work with VBP entities needing care coordination services and with patient-focused programs (e.g., chronic kidney disease, high cost/high ER)

· Facilitate requests for data from VBP entities and coordinate with Data Analysis/BSS staff.

· Ensure appropriate and timely documentation of VBP-related and other interactions with providers in Salesforce for monitoring and performance tracking.

· Develop and maintain high level understanding and industry knowledge in the areas of medical loss ratio, total cost of care, quality related performance measures (e.g., HEDIS, CMS Star rating, etc.), shared savings, financial concepts (such as IBNR, pmpm, premium, medical costs, HMO operations (claims processing, member enrollment and assignment, attribution, provider relations, health coordination)

· Supports production of reports including fulfillment of state contractual requirements and organizational needs.

· Seeks and shares industry information that informs AlohaCare of current issues in the health industry and communities we serve.

Education of Providers

· Train VBP entity staff on use of AlohaCare’s VBP reporting tools and scorecards.

· Coordinate and conduct provider educational and training activities including presentations in large and small group, one-on-one and online settings.

· Assist in the development of educational and training materials and logistical arrangements for education and training events.

Other Responsibilities

· Facilitate inter-departmental collaboration for projects, process improvement and on-going operations.

· Responsible for maintaining AlohaCare’s confidential information in accordance with AlohaCare policies, and state and federal laws, rules and regulations regarding confidentiality. Employees have access to AlohaCare data based on the data classification assigned to this job title.

Required Competencies & Qualifications of a Value Based Program (VBP) Coordinator:

· Bachelor’s degree or 3 years minimum analytical/contract healthcare experience.

· Minimum of three years of industry knowledge in value-based contracting with understanding of medical loss ratio, total cost of care, quality performance, and financial concepts (i.e., shared savings)

· Current valid Hawaii driver’s license and access to an insured vehicle

· Strong relational, verbal, and written communication skills.

· Public speaking and interpersonal interaction.

· High energy level and ability to perform repetitive tasks in a fast-paced work environment.

· Flexibility and adaptability to changing priorities.

· Intermediate skill using Microsoft Programs; Word, Excel, Outlook and PowerPoint.

· Ability to think critically with strong multi-tasking skills.

Preferred Competencies & Qualifications of a Value Based Program (VBP) Coordinator :

· Master’s degree

· Provider and/or health plan experience

· Medicaid and/or Medicare experience.

Working Conditions/Physical Demands of a Value Based Program (VBP) Coordinator :

· Inside/Outside working conditions.

· No environmental hazards.

· Sedentary Work: Exerting up to 20 pounds of force occasionally and/or a negligible amount of force frequently or constantly to lift, carry, push, pull, or otherwise move objects. Sedentary work involves sitting most of the time but may involve walking or standing for brief periods of time. Jobs are sedentary if walking and standing are required only occasionally, and all other sedentary criteria are met.

· Requires occasional inter-island travel with occasional overnight stays.

· Requires verbal and written communication in English.

Salary Range: $55,000 - $70,000 annually

AlohaCare is committed to providing equal employment opportunities to all applicants in accordance with sound practices and federal and state laws. Our policy prohibits discrimination and harassment because of race, color, religion, sex (including gender identity or expression), pregnancy, age, national origin, ancestry, marital status, arrest and court record, disability, genetic information, sexual orientation, domestic or sexual violence victim status, credit history, citizenship status, military/veterans’ status, or other characteristics protected under applicable state and federal laws, regulations, and/or executive orders.

Job Type: Full-time

Pay: $55,000.00 - $70,000.00 per year

Benefits:

• 401(k)
• 401(k) matching
• Dental insurance
• Employee assistance program
• Flexible spending account
• Health insurance
• Paid time off
• Vision insurance

Schedule:

• Day shift
• Monday to Friday

Ability to commute/relocate:

• Honolulu, HI 96814: Reliably commute or planning to relocate before starting work (Required)

Experience:

• analytical/contract healthcare: 3 years (Required)
• value-based contracting: 3 years (Required)

License/Certification:

• Driver's License (Required)

Work Location: Hybrid remote in Honolulu, HI 96814

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