Directs, coordinates, and provides oversight to M Health Fairview value-based care projects and programs advancing our ability to meet the quadruple aim through the Optimal Care program.
Develops Optimal Care program infrastructure and capabilities. Supports enterprise planning of initiatives, projects, and metrics for value-based care transformation. Advances the organization's culture to provide high-value care. Drives performance using a data-driven approach.
Helps optimize performance for value-aligned incentives, alternative payment models, and other population health metrics across the system for more reliable, equitable, and high quality care. Initiatives will cover a broad range of content including but not limited to alternative payment models, network performance, acuity coding, provider alignment, and transforming sites and modalities of care.
Manages components of value-based payment design and initiatives working collaboratively with a wide range of system functions including service lines, domains, the clinically integrated network, care management functions, and supporting functions.
Works collaboratively with key supporting partners including data analytics, payer relations (product development/product management, contracting), and quality on initiatives.
This position reports to the System Director of Population Health and Value-Based Care.
Collaborates with stakeholders across the organization and continuum of care. Leads teams around Optimal Care Program initiatives.
Uses system methodology for value-based care initiatives to assure reliable and improved performance in the M Health Fairview organization.
Educates clinicians and operational staff on their performance.
Maintains knowledge of and complies with alternative payment models and best practices around value-based care transformation.
As applicable, partners with data analytics, quality and safety, care coordination, and payer relations to ensure external value-aligned reporting requirements are met..
Manages relationships with data analytics, quality, payer relations, the clinically integrated network, and clinical operations to drive system performance, including initiatives around population health, clinical variation reduction, programs around clinical risk management, and network performance.
Directs the planning, implementation and evaluation of value-based care outcomes
using evidence-based and innovative approaches to improve population health and total cost of care. Identifies, recommends, and implements changes that will improve productivity and/or financial performance. Prepares/assists in the financial forecast and monitors program/project health for monthly variances to plan. Collaborates with and motivates others to achieve program/project goals and objective.
Contributes to a culture of learning for team and wider organization. Serves as an expert resource on value-based care throughout M Health Fairview. Develops related education programs to meet identified needs to aid in transforming the organization.
Assists colleagues on team to be oriented to the organization, business unit and position. Actively participates in creating and implementing improvements within the Optimal Care team and collaborates on improvements with adjacent functions.
Creates a collaborative environment despite ambiguity and uncertainty providing tools and resources to address the needs of teams and workgroups in around initiatives.
Masters degree or higher in Health-related field such as Business Administration, Healthcare Administration, or related field or a combination of equivalent education and experience.
Minimum 4 years of education or experience required in relevant field, including health care, quality or process improvement, direct patient care, or healthcare analytics
1-2 years leadership experience
Strong organizational skills, demonstrated analysis and problem-solving skills.
Ability to work independently with strong vision and deliverables aligned with strategic goals.
Excellent oral and communications skills.
Demonstrated ability to establish and maintain working relationships with peers and stakeholders at all levels of the organization.
Great understanding of the organization, organizational dynamics, and clinical operations.
Registered Nurse MN (RN), Advanced Practice Provider (NP, PA), or Medical Doctor (MD, DO)
Experience with and knowledge of advanced alternative payment models, including Next Generation ACO, Merit-Based Incentive Payment systems (MIPS), MACRA legislation, Minnesota Community Measures (MNCM), Quality Payment Programs (QPP), Primary Care Direct, Bundled Payment programs, Medicare Advantage, and other value-aligned initiatives.
Expertise in population health, quality, or directly in primary care knowledge of practices that support health disparities, variations in the population serviced, and provider alignment initiatives.
Background or experience in clinical operations and quality.
Previous experience with payer relationships/product development around value-aligned specifications
A track record with clinical programs and models of care. Experience with care management and at-risk patient populations.
Knowledge of accreditation and healthcare regulations related to value-based care programs at a state and national level.
Knowledge and experience with providers and clinically integrated network performance and infrastructure.
Formal project management or improvement methodology certification.
Together with the University of Minnesota and University of Minnesota Physicians we have created M Health Fairview. M Health Fairview is the newly expanded collaboration among the University of Minnesota, University of Minnesota Physicians, and Fairview Health Services. The healthcare system combines the best of academic and community medicine — expanding access to world-class, breakthrough care through our 10 hospitals and 60 clinics.
Fairview Health Services (fairview.org) is an award-winning, nonprofit health system providing exceptional care across the full spectrum of health care services. Fairview is one of the most comprehensive and geographically accessible systems in the state, with 10 hospitals—including an academic medical center and long-term care hospital—serving the greater Twin Cities metro area.
Its broad continuum also includes 60 primary care clinics, specialty clinics, senior living communities, retail and specialty pharmacies, pharmacy benefit management services, rehabilitation centers, counseling and home health care services, medical transportation, an integrated provider netwo...rk and health insurer PreferredOne. In partnership with the University of Minnesota, Fairview’s 32,000 employees and 2,400 affiliated providers embrace innovation to drive a healthier future through healing, discovery and education.