Leads the development of a member/beneficiary messaging, communications, and engagement strategy for the Managed Population Risk Division that aims to welcome/onboard, educate, engage, incentivize, and provide ongoing guidance to members and beneficiaries regarding services and benefits available to them within the program structure, and to assist with navigating the healthcare system.
Acts as an account manager, leading the strategic planning and designing programs that will be deployed/executed in local markets.
Knowledgeable on government program requirements and ensures compliance within the team and strategies executed.
Identifies, using data-driven approaches and analytics, key initiatives to improve patient engagement
Understands population demographics and key factors influencing ability/willingness to engage and creates strategies that specifically target the various segments identified with the goal of reducing the total cost of healthcare spend.
Expert in program requirements and guidelines and studies best practices in the industry to guide thinking, planning, and execution of member/beneficiary engagement and incentive programs.
Works cross-functionally to execute initiatives and achieve key goals, for example, collaborating with consumer and patient engagement leadership in the organization to leverage internal resources, expertise, and insights to guide planning and execution.
Develops and executes a multimedia member/beneficiary outreach and education plan on program components (i.e. print/electronic educational materials, outreach strategy, in person events, etc), in compliance with regulators such as the Centers for Medicare & Medicaid services (CMS)
Works collaboratively with clinical, population health, and consumer/experience teams to develop a member engagement platform
Evaluates available program incentives and potential impact to member/beneficiary engagement and program performance. Collaborates with clinical, analytics, finance, and actuarial teams to evaluate opportunities in the population and model out potential impact in order to make recommendations to program leadership for targeted incentive and reward plans.
Models, tracks, and measures key metrics of success and outcomes of programs and strategies implemented.
What You Will Need:
Education and Experience Required:
Bachelor’s degree in a related field, such as Business, marketing, or Communications, etc. AND a minimum of three years of experience in an ACO, health plan, or CIN sufficient to yield the knowledge requirements above OR
A minimum of eight years of experience in an ACO, health plan, or CIN sufficient to yield the knowledge requirements above.
Knowledge and Skills Required:
Working knowledge of all aspects of a typical ACO, health plan, CIN, value-based programs, health system, or physician practice including customer service, network management, data exchange, claims processing, sales and underwriting, marketing, benefit plan design, medical management, quality management, finance, risk adjustment, regulatory oversight, and compliance.
High-level interpersonal skills. Able to work collaboratively and tactfully with multi-disciplinary and diverse teams across department lines, management levels, and business entities.
High degree of emotional intelligence and self-management ability. Able to remain calm, focused, and productive in stressful situations, conflicts.
Excellent organizational, planning and time management skills.
Strong attention to detail.
Excellent analytical and problem-solving skills
Effective oral and written communication skills, with the ability to articulate complex information in understandable terms to all levels of staff.
Effective computer skills, particularly Microsoft Office Outlook, Word
Proficient Microsoft Excel skills, including accurate sorting and filtering, VLOOKUP's, Pivot Tables.
The Director of Member and Beneficiary Engagement reports to the Population Health Services Organization (PHSO) Vice President of Care Integration. The Director of Member and Beneficiary Engagement is responsible for designing, developing, executing on, and measuring the effectiveness of member and beneficiary messaging, communication, and engagement strategies. These strategies may include outreach/onboarding, education, implementation of member/beneficiary benefit enhancements or incentives to promote engagement, leveraging a robust omnichannel communication platform. Director is responsible to develop and design methods, programs, and robust frameworks around people, process, and technology to execute, in collaboration with other AdventHealth resources or teams, or through direct operations. The director will work cross functionally to execute on these initiatives to achieve the stated goals, leveraging internal tools, resources, and working collaboratively with teams inside and outside of the PHSO and Managed Risk Division. The Director is responsible for understanding and being the internal expert on program requirements and compliance rules/regulations that relate to the execution of these strategies.
The Director objectively evaluates and measures the performance of the staff and team to ensure efficiency and maintain standard operations that complies with all regulatory guidelines and is leveraged for optimization. Identifies and reports on process improvement opportunities to the Vice President. Actively seeks to model the achievement of excellence. Promotes teamwork by personally adopting principles of caring and integrity. Actively participates in outstanding customer service and accepts responsibility in maintaining relationships that are equally respectful to all.
At AdventHealth, Extending the Healing Ministry of Christ is our mission. It calls us to be His hands and feet in helping people feel whole. Our story is one of hope — one that strives to heal and restore the body, mind and spirit. Our more than 80,000 skilled and compassionate caregivers in hospitals, physician practices, outpatient clinics, urgent care centers, skilled nursing facilities, home health agencies and hospice centers are committed to providing individualized, wholistic care.