Job Description
Why Join CINQCARE?CINQCARE is a provider-led, community-based health and care partner dedicated to improving the health and well-being of those who need care the most, with a deep commitment to high-needs, urban and rural communities. Our local physicians, nurses, and caregivers work together to serve people and the communities they live in, beyond just treating symptoms. We remove barriers by delivering personalized care as close to home as possible, often in-home, because we know a deep understanding of our patient's race, culture, and environment is critical to delivering improved health outcomes. By empowering patients, providers, and caregivers with the support they need, we strive to make health and care a reality-not a burden-every single day. Join us in creating a better way to care.
Position OverviewThe Vice President of Practice Transformation will report to the Chief Clinical Operations Officer. This role will be accountable for providing evidenced-based analysis, strategy and optimized processes to facilitate performance improvement within the provider practices. This individual will lead the overall team of PTFs. This individual should embody CINQCARE's core values, including,
Trusted, Empathetic, Committed, Humble, Creative and Community-Minded. At CINQCARE, we don't have patients or customers - we have Family Members.
Key Responsibilities- The Practice Performance Leader will lead the team responsible for assisting and supporting our CINQCARE practice partners
- Drive strategy around improvement opportunities, in partnership with the medical practice leadership team, through root cause analysis and action plans
- Set performance expectations with medical practices, based on contractual obligations. Engenders practice accountability for change/improvements. Monitor and track key performance indicators (KPIs) related to accurate and timely documentation requirements.
- Fosters a team of practice facilitators that can build trust and buy- in with key stakeholders and care teams to facilitate change management, engagement, solutioning, and sustainability of population health initiatives.
- Support Quality and Risk Adjustment improvement initiatives by assessing current state and collaborates with key stakeholders on population health efforts.
- Displays strong time management and communication skills that align with CINQCARE's core values.
- Monitor, interpret, and track HEDIS and other quality performance measures, at a practice, market and national level, to optimize care outcomes and maximize revenue.
- Drives success in population health performance by guiding practice teams to achieve best practice standards/benchmarks by providing ongoing provider engagement, training, and coaching.
- Possesses a solid knowledge of internal enterprise-wide contractual areas of focus, Medicaid VBP and Medicare entities to monitor and report metrics such as utilization trends, patient satisfaction, and other key performance indicators
- Manage the end-to-end process to ensure accurate and timely documentation and coding of medical procedures and diagnoses in compliance with coding guidelines and regulations (ICD-10, CPT, HCPCS).
- Stay abreast of changes in healthcare regulations, payer policies, and reimbursement trends to ensure compliance and maximize revenue opportunities.
- Support internal and medical practice staff training and education programs to enhance accurate and timely documentation for medical procedures and diagnoses.
- Mange Practice Transformation Facilitator team and ensure team members can:
- Facilitate practice level meetings with practice champion to monitor, and track practice performance.
- Monitor and prioritize key performance metrics throughout the transformation process. Coordinates, as appropriate, practice interactions and/or follow-up with other CINQ Care functional areas. Works cross functionally with Network Management/Provider Relations, Medical Economics, and Data Analytics to optimize success.
- Collaborate with health plans to resolve operational and roster and panel management issues.
- Supports the practice by conducting member outreach and engagement calls to facilitate access to care, close care gaps, meet HEDIS Measures, assist the clinical team in scheduling transition of care, and coordinate risk adjustment visits.
- Perform PDSA cycles to implement change, solve problems, and continuously improve processes.
Required Qualifications- Education/Experience:
- BA/BS, clinical license (RN) preferred
- Experience with analytical skills and data analysis plus experience is HEDIS/STARS at the practice level.
- Experience with diagnoses coding
- Experience in Quality Improvement, and/or facilitation skills preferred.
- Physician/Provider/Hospital practice level experience required.
- Experience in Value Base Care & Practice Transformation efforts required.
- The ideal candidate will have experience in primary care practice performing practice transformation efforts.
- Computer Knowledge:
- Excellent computer skills required particularly related to Microsoft applications including Word. Excel, PowerPoint, and Outlook.
- Experience with PowerBI preferred
- Willingness required to explore and learn new or unfamiliar applications and databases, and when prepared to teach practices and team members how to maximize technology
Our Benefits At CINQCARE, we care for our team like we care for our patients-holistically. We offer flexible, comprehensive benefits so you can thrive while delivering top-notch care.
- Medical Plans: Two comprehensive options offered to Team members.
- 401K: 4% employer match for your future.
- Dental & Vision: Flexible plans with in-network savings.
- Paid Time Off: Generous PTO, holidays, and wellness time.
- Extras: Pet insurance, commuter benefits, mileage reimbursement, CME for providers, and company-provided phones for field staff.
The working environment and physical requirements of the job include:In-office work is performed indoors in a traditional office setting with conditioned air, artificial light, and an open workspace.
In this position you will need an to communicate with customers, vendors, management, and other co-workers in person and over devices, sometimes with people who are agitated. Regular use of the telephone and e-mail for communication is essential. Sitting for extended periods is common. Must be able to receive ordinary information and to prepare or inspect documents. Lifting of up to 10 lbs. occasionally may be required. Good manual dexterity for the use of common office equipment such as computer terminals, calculator, copiers, and FAX machines. Good reasoning ability is important. Able to understand and utilize management reports, memos, and other documents to conduct business.
Equal Opportunity & Reasonable Accommodation StatementCINQCARE is an Equal Opportunity Employer committed to creating an inclusive environment for all employees. We provide equal employment opportunities to all individuals regardless of race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or any other protected characteristic under applicable law.
If you require a reasonable accommodation during the application or employment process, please indicate this in your application or speak with your recruiter during the hiring process.
DisclaimerThis job description is intended to describe the general nature and level of work being performed. It is not intended to be an exhaustive list of all responsibilities, duties, and skills required. Management reserves the right to modify, add, or remove duties as necessary.
