Population Health Manager - Lumeris : Job Details

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Position:

Population Health Manager

Position Summary:

Responsible for improving Accountable Care Team (Provider) engagement. Establishes significant mindshare within our Accountable Care Team partners including: physicians, nurses, administrative staff and management. Improves awareness, adoption and utilization of ADSP related quality and service offerings. Works to positively influence ACT behavior empowering value based care, quality and cost & utilization. Plays a critical role in fortifying the collaborative relationship we seek to establish with our physicians at the practice or clinic level.

Job Description:

Primary Responsibilities

* Responsible for practice transformation including practice observations, review of findings, best practice recommendations related to a practice's readiness for value-based care.

* Coaches on pre-visit planning and closure of gaps in care.

* Provides high-risk patient follow-up (after inpatient discharge, after ER visit, for complex cases).

* Enhances access to care and referral network optimization.

* Identifies pharmacy management opportunities (promoting generics, medication adherence, step therapy).

* Ensures comprehensive and accurate documentation and coding of risk-adjusted patient populations to ensure appropriate risk score and revenue capture.

* Develops and implements initiatives to improve performance against value-based contract metrics.

* Establishes strong personal relationships with Accountable Care Teams: physicians, nurses, administrative staff and management.

* Develops and delivers programs, training, and adoption to client.

* Responsible for deliverables of client engagements, including project timelines and logistics.

* Provides subject-matter expertise in program development and solution packaging.

* Keeps abreast of current industry, market, and policy landscape.

Qualifications

* Bachelor's degree or equivalent

* 3+ years of client-facing experience within the healthcare domain or the knowledge, skills, and abilities to succeed in the role

* Experience working with physician practices including; provider relations, provider education, practice transformation and/or practice management

* Skilled at change management

* Demonstrated subject matter expertise in any of the following areas: Medicare advantage, Medicare Shared Savings Program (MSSP), managed care regulations, quality reporting, care management, population management, ACO strategy implementation and operations, and supporting providers in risk based contracts

* Strategic and entrepreneurial outlook with strong collaborations skills

* Ability to guide complex client interactions at C-level

* Ability to operate in a fast-paced and dynamic environment

* Team player, excellent communication skills

* Demonstrated understanding of healthcare metrics and use of analytical skills

* Extensive knowledge of the U.S. healthcare system

* Strong client-facing skills

* Solid presentation skills

Working Conditions

* While performing the duties of this job, the employee works in normal office working conditions.

Disclaimer

* The job description describes the general nature and level of work being performed by people assigned to this job and is not intended to be an exhaustive list of all responsibilities, duties and skills required. The physical activities, demands and working conditions represent those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential job duties and responsibilities.

Lumeris is an EEO/AA employer M/F/V/D.

The hiring range for this position is:

$72,800.00-$97,400.00

Factors that may be used to determine your actual pay rate include your specific skills, experience, qualifications, location, and comparison to other employees already in this role. This role may also be eligible for incentive compensation. At Lumeris, we are committed to providing a total rewards package that supports your overall well-being. Our benefits include medical, vision, dental, well-being programs, 401(k) with company matching, life insurance, paid time off including paid leave, and so much more. Learn more by visiting our Careers Page.

Member Facing Position:

Yes- Member or Patient Facing Position

Location:

Illinois

Time Type:

Full time

Lumeris and its partners are committed to protecting our high-risk members & prospects when conducting business in-person. All personnel who interact with at-risk members or prospects are required to have completed, at a minimum, the initial series of an approved COVID-19 vaccine. If this role has been identified as member-facing, proof of vaccination will be required as a condition of employment.