Manager, Value-Based Care Operations
$100,000–$120,000 year
RemoteUnited States
Job Summary
Coordinate and monitor EMR quality report delivery, validate Social Determinants of Health data, and resolve reporting discrepancies with affiliate back-office teams. Compile, analyze, and distribute monthly performance packages and billing bifurcation reports while maintaining accuracy across ACO programs. Serve as the primary liaison to provider groups, vendors, and internal stakeholders to drive operational excellence, implement updated workflows in the ACO Operations Manual, and ensure compliance with CMS requirements. Manage recurring regulatory submissions and secure data transfers via SFTP to support program integrity.
Required Qualifications
- Bachelor's degree in Healthcare Administration, Business Administration, Public Health, Health Information Management, or related field
- 3–5 years of experience in healthcare operations, quality reporting, healthcare analytics, population health, value-based care, or a similar healthcare environment
- Advanced Microsoft Excel skills, including experience working with large datasets, Pivot Tables, XLOOKUP/VLOOKUP, data validation, reconciliation, trend analysis, reporting, and data analysis
- Hands-on experience working with EMR/EHR systems and healthcare reporting data
- Experience analyzing, validating, and distributing operational and quality reports
- Experience working directly with external affiliates, providers, vendors, and internal stakeholders
- Proven experience managing multiple projects, priorities, and deadlines in a fast-paced environment
- Strong analytical, problem-solving, critical thinking, written communication, and verbal communication skills
- Exceptional organizational skills and attention to detail
- Ability to build and maintain productive relationships with providers, affiliates, vendors, and cross-functional stakeholders
- Strong customer service orientation and the ability to effectively manage stakeholder expectations
Desired Qualifications
- Experience supporting Accountable Care Organizations (ACOs), Medicare Shared Savings Program (MSSP), population health, or value-based care programs
- Experience supporting healthcare quality improvement initiatives and provider performance programs
- Experience collaborating with EMR vendors and external healthcare organizations
- Familiarity with CMS quality and reporting programs, including: Merit-based Incentive Payment System (MIPS), Promoting Interoperability (PI), Social Determinants of Health (SDOH)
- Knowledge of healthcare quality metrics, provider performance measurement, and regulatory reporting requirements
- Understanding of operational process improvement and workflow optimization within healthcare environments
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