Director, Direct Contracting Entities

Job Number: 2867

Workplace Type:

Position Title: Director, Direct Contracting Entity

External Description:

Position Summary:

 The Director of Direct Contracting Entity will be responsible for overseeing and directing all population health functions for Direct Contract Entities, in support of organization’s strategic plan. Direct Contracting is a financial risk-sharing arrangement with Centers for Medicare & Medicaid Services (CMS) to reduce Medicare expenditures while preserving or enhancing the quality of care furnished for traditional Medicare beneficiaries.

 General Duties/Responsibilities:

(May include but are not limited to)

 

• Serving as a member of the operations leadership team, collaborating with DC Participating Providers and Preferred Providers, executive leadership, and teams across the business to drive progress towards operational goals and overall DCE key metrics.
• Drive accountability amongst team and across provider network to meet key outcomes for cost and quality.
• Maintain a critical role in performance management by guiding actionable initiatives from data; measuring progress and outcomes and helping implement interventions where applicable.
• Ensure integration of care management, utilization management, risk adjustment, annual wellness visit and quality initiatives into practices and achieving goals.
• Collaborating with data analytics team to ensure alignment across business, operational requests, and practice needs.
• Continuously drive improvements to performance management for efficiencies and outcomes
• Develop strategy to build, grow, and sustain relationships with physician leaders and leveraging practice relationships to engage, implement, and sustain DCE priorities
• Develop practice manager and care management liaison relationship strategy
• Develop agendas/contents for joint operating meetings (JOC) with DC Participating Providers
• Ensure consistent implementation of high quality internal and external reporting and utilization of engagement tools
• Work collaboratively and cross functionally with internal departments

 

Supervisory Responsibilities:

 Currently, no direct reports

 

 

 

 

 

Minimum Requirements:

 

1. Minimum Experience: Bachelor’s or Master’s Degree in business or healthcare preferred. 5+ years of leadership experience in ACO Management, value-based care organization, IPA or medical group management, performance improvement and leadership with people management experience.
2. IPA and/or ACO experience with a provider perspective and strong orientation to value-based care principles, health policy landscape, CMS compliance requirements.
3. Working knowledge of clinical quality metrics such as RAF, HEDIS, CAHPS
4. Analytic skills and hypothesis driven to identify trends, predict issues, highlight critical areas, and develop corrective action plans.
5. Ability or willingness to travel (post Covid 19).
6. Proficient in Microsoft Office Products (Excel, PowerPoint, Word).
7. Excellent written and oral presentation skills, with the ability to engage, inspire, build credibility and trust.
8. Highly organized, self-motivated individual with the ability to adapt to various workspaces and work autonomously.
9. Collaborative working style with the ability to work across different teams, areas of expertise, and adapt to ambiguous environments and clientele.
10. Currently, position is work remotely and may progress to office location in future. Required to have following technical capability at their home: High Speed Internet
11. Must be located in North Carolina

 

 

 

Essential Physical Functions:

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

 

1. While performing the duties of this job, the employee is regularly required to talk or hear. The employee regularly is required to stand, walk, sit, use hand to finger, handle or feel objects, tools, or controls; and reach with hands and
2. The employee frequently lifts and/or moves up to 10 pounds. Specific vision abilities required by this job include close vision and the ability to adjust

 

 

FLSA Status: Exempt

City: Remote-North Carolina

State: North Carolina

Location City: Remote-North Carolina

Location State: North Carolina

Community / Marketing Title: Director, Direct Contracting Entities

Company Profile:

By leveraging our world-class technology platform, innovative care delivery models, deep physician partnerships and our serving heart culture, Alignment Health is revolutionizing health care for seniors! From member experience professionals and clinicians, to data scientists and operations leaders, we have built a talented and passionate team that is deeply committed to our mission of transforming health care for the seniors we serve. Ready to join us?

At Alignment, delivering exceptional care to seniors starts with ensuring an exceptional experience for our over 1,300 employees. At the center of our employee experience is a culture where employees at all levels and across all teams are encouraged to share their unique ideas and perspectives. After all, when you can bring your authentic self to work, whether that’s in a clinical setting, our corporate office or a home office, creativity and innovation flourish! Another important part of the Alignment culture is a belief in continuous learning and growth. As a result, in this fast-growing company, you will find ample support to grow your skills and your career – with us.

EEO Employer Verbiage:

 

Please note: All clinical positions are contingent upon successful engagement with Alignment Health’s COVID-19 Vaccination program (fully vaccinated with documented proof or approved exception/deferral).

Alignment Health is an Equal Opportunity/Affirmative Action Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability, age, protected veteran status, gender identity, or sexual orientation.

*DISCLAIMER: Please beware of recruitment phishing scams affecting Alignment Health and other employers where individuals receive fraudulent employment-related offers in exchange for money or other sensitive personal information. Please be advised that Alignment Health and its subsidiaries will never ask you for a credit card, send you a check, or ask you for any type of payment as part of consideration for employment with our company. If you feel that you have been the victim of a scam such as this, please report the incident to the Federal Trade Commission at https://reportfraud.ftc.gov/#/. If you would like to verify the legitimacy of an email sent by or on behalf of Alignment Health’s talent acquisition team, please email [email protected].