Value Based Care Representative

Voted “Business of the Year” 2018 and one of the “Fastest Growing Companies in the Triad” 2019–2022, Bethany Medical is the largest independent, established multi-specialty group in Central North Carolina. Our mission is to provide excellent care through a multi-specialty approach from prevention to intervention of potentially life-threatening health problems.

About the role

The Value-Based Care Representative works with medical leadership and the value-based care team to improve provider performance on QC clinical quality metrics, hierarchical condition category (HCC) coding metrics, utilization and steerage efficiencies, and cost control metrics. This position uses data and reporting on clinical performance for direct-to-provider interventions and strategic improvement, focusing on user experience, education, EMR data, workflow enhancements, and implementation of enhanced QC knowledge.

Responsibilities

• Uses VBC reporting on HEDIS/STARS quality, HCC/RAF coding, healthcare service cost and utilization, patient steerage patterns, etc., to design and implement innovative performance improvement strategies for practices and providers
• Collaborates with the medical leadership team to understand barriers to closing quality care gaps and effectively coding for services performed
• Interprets information from multiple data sources (internal, ACO, and third-party payer) to create a comprehensive performance visualization
• Applies knowledge of healthcare systems, operations, program design and implementation, technology, and innovation to maximize data impact
• Demonstrates a collaborative, team-first attitude, transparently sharing ideas and data
• Works flexibly within a team atmosphere, pivoting approach as needed
• Performs administrative duties as workload necessitates
• Possesses a working knowledge of healthcare coding (ICD 10, CPT codes, etc.)
• Demonstrates strong knowledge of provider workflows and practice performance
• Maintains company confidentiality in all areas
• Possesses a strong knowledge of health care models, including ACOs
• Uses superior communication skills—speaks effectively in all environments; listens, requests clarification, and responds well to feedback
• Demonstrates flexible and efficient time management and ability to prioritize workload

Requirements

• 2+ years of experience in the health industry; care gap management and/or coding preferred
• 2+ years of experience working with medical professionals preferred; clinical experience, provider relations, value-based care, etc.
• Organized and self-motivated
• Proficient computer skills, including Word and Excel spreadsheets, data entry, electronic medical record (EMR) / Practice Management (PM) systems, and analysis tools
• Excellent communication skills with the ability to work collaboratively with physicians, staff, and external organizations
• Strong phone skills, comfortable with patient engagement
• Strong customer service skills
• Ability to manage multiple tasks/projects simultaneously
• Comfortable with continuous change and self-initiating
• Use conflict resolution skills when reaching consensus about plans of care and treatment decisions
• Experience with Value-Based Care programs required

Qualifications

• A bachelor’s degree in a related field is preferred
• Certified Medical Assistant certificate preferred; RNs also welcome to apply

Benefits

• Employee medical, dental, and vision insurance; family coverage available at a discounted rate
• Employee Life Insurance
• Generous PTO and paid company holidays
• Employee Short-Term Disability
• 401-K with company matching
• Earned Wage Access (EWA)—get part of your earned pay before payday

About Bethany Medical

Bethany Medical is the largest independent, established multi-specialty group in Central North Carolina, serving the Triad and surrounding communities for over 35 years. With 13 convenient locations and 16 practices in Greensboro, Winston-Salem, High Point, Kernersville, Jamestown, North Wilkesboro, and Mt. Airy, North Carolina, Bethany Medical is open 7 days a week. We provide urgent care, primary care, diagnostic testing, outpatient ancillary, and specialty care services onsite, staffed with board-certified physicians and providers representing over 16 medical specialties.

About the Triad

The Triad area includes Greensboro (the third-largest city in NC), Winston-Salem, High Point, and the surrounding area, with a population of 1.9 million. Centrally located in NC, the Triad is 1 hour from the mountains and 3 hours from the beach. Charlotte and Raleigh are 1.5 hours away. The Triad offers all the amenities of a larger city without heavy traffic, including the Piedmont Triad International Airport in Greensboro with non-stop flights to most major cities. Enjoy arts, entertainment, recreation, shopping, and hundreds of restaurants, along with 85 colleges and universities such as Wake Forest University, High Point University, UNC-Greensboro, NC A&T, Guilford College, Bennett College, and Greensboro College.