Job Description
Title: Director of Network Solutions
Location: Remote
About Our Company
Vytalize Health is a leading value-based care platform for seniors that has raised over $70 million in financing from top healthcare investors. We partner with primary care practices and power them through bold financial incentives and smart technology. We combine a Medicare ACO, virtual and in-home doctors’ office, and a digital health platform to equip our network of physicians with everything they need to be successful in caring for their patients and staying ahead in a rapidly changing healthcare system. Our private equity-backed company works with over 500 providers and manages more than $2 billion in annual medical spending.
About our Growth
Vytalize Health has grown its patient base 150% year-over-year and is now partnered with 280 primary care practices across 16-states. The company’s all-in-one, vertically integrated solution for value-based care delivery is responsible for $2 billion in medical spending. The company is expanding into new markets while increasing the concentration of practices in existing ones and has begun contracting with regional and national Medicare Advantage plans.
Visit www.vytalizehealth.com for more information.
Why you will love working here
We are an employee first, mission driven company that cares deeply about solving challenges in the healthcare space. We are open, collaborative and want to enhance how physicians interact with, and treat their patients. Our rapid growth means that we value working together as a team. You will be recognized and appreciated for your curiosity, tenacity and ability to challenge the status quo; approaching problems with an optimistic attitude. We are a diverse team of physicians, technologists, MBAs, nurses, and operators. You will be making a massive impact on people’s lives and ultimately feel like you are doing your best work here at Vytalize.
Job Description
We are currently looking for a Director of Network Solutions to identify network optimization opportunities in the ancillary space, with a strong focus on post-acute (skilled nursing facilities, rehabilitation, home health). The objective is to identify and architect clinical and financial improvements to improve quality, return patients to normal daily functions more rapidly, and to reduce unnecessary overall and patient out of pocket expenses to support our Medicare ACO REACH and Medicare Advantage programs. This position will work closely with Network Development leaders to understand and model network design and payment innovation ideas, working closely with Vytalize Health’s database tools and the IT staff to organize and present data to support initiatives. This role combines a knowledge of VBC payment innovation with an intimate understanding of the post-acute space, claims, coding, and database and Business Intelligence tools and technologies.
This is an exciting opportunity for a talented, data-oriented, and experienced healthcare professional that is goal-oriented, with a unique mix of business, value based care, payment model, and technology experience, as well as leadership presence, and great communication skills to drive rapid growth & execution across internal stakeholders and provider partners.
The right candidate will be a doer with the ability to analyze market opportunities, effectively and efficiently communicate business requirements, and systematically work to balance time to market and solution capabilities.
What You Will Do
- Work with Network VP’s, Chief Operating Officer, ACO Medical Directors, and partners to understand our strategic goals and needs to drive the development of payment models, databases, and BI dashboards to give insight into achieving those goals
- Create early adopter solutions that can be used to prove models prior to full development
- Understand Network business objectives and analyze current technology utilized within the company to define solution roadmaps
- Identify which PAC providers are appropriate for Vytalize Preferred Provider status through data analytics and connect with chief decisions
- Build trust relations with key contacts and act as a point of contact for provider leadership collaboration and program development, introducing Vytalize’s objective and the win-win value proposition for PACs
- Design collaborative win-win processes between acute care and preferred PAC providers in order to direct admission flow to preferred providers
- Establish policy and procedure for PAC admissions including ongoing communication and support through discharge from PAC facility in order to decrease length of stay and reduce risk of rehospitalization
- Help establish communication workflow between discharging SNF and community based care (PCP and CHHAs) to ensure follow up care and reduce risk of rehospitalizations (SNF admin exp, clinical experience)
- Own network performance reporting design for post-acute providers, to be used by providers to monitor their adherence and Vytalize Health management to measure progress towards goals
- Problem solve in concert with the Analytics department on business processes for timely, complete, accurate data to support Post-acute network solutions
- Document and guide Network Management teams to successfully roll-out programs, train providers, monitor progress of initiatives, and refine dashboards to support ongoing value creation
What You Need
- Bachelor’s degree; Master’s preferred
- Minimum 10 years’ previous experience in value based care and payment innovation
- Detailed understanding of PAC (SNF, home health, etc.) operations and opportunities to create efficiencies
- Experience in and understanding of fee for service, pay for performance, risk share, and capitation payment arrangements
- Knowledge of utilization management and care management as tools to drive value
- Understanding of CMS programs (Medicare ACO) and Direct Contracting / ACO REACH and Medicare Advantage
- Experience in provider data structure, claims processing, EDI transactions, and other data elements needed for successful dashboard creation
- Up-to-date on the latest industry trends; able to articulate trends and potential financial opportunities clearly and confidently
- Excellent interpersonal skills and ability to communicate with all levels of management
- Able to multitask, prioritize, and manage time efficiently
- Familiarity with contract language from a business perspective
- Ability to work independently and collaboratively
- Excellent written and verbal communication skills
- Ability to travel as needed (minimal)
Perks/Benefits
- Competitive base compensation
- Annual bonus potential
- Health benefits effective on start date; 100% coverage for base plan, up to 90% coverage on all other plans for individuals and families
- Health & Wellness Program; up to $300 per quarter for your overall wellbeing
- 401K plan effective on start date; 100% of up to 4% of your annual salary
- Company paid STD/LTD
- Technology setup
- Ability to help build a market leader in value-based healthcare at a rapidly growing organization
Please note at no time during our screening, interview, or selection process do we ask for additional personal information (beyond your resume) or account/financial information. We will also never ask for you to purchase anything; nor will we every interview you via text message. Any communication received from a Vytalize Health recruiter during your screening, interviewing, or selection process will come from an email ending in @vytalizehealth.com
