Value Based Care Representative

Bethany Medical is the largest independent, established multi-specialty group in Central North Carolina, serving the Triad and surrounding communities for over 35 years. We are seeking a Value-Based Care Representative to join our team in our Triad locations, including Greensboro, High Point, Winston-Salem, Kernersville, Mt Airy, and North Wilkesboro, North Carolina. This role will be based out of our High Point Corporate Office.

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 well within a team atmosphere, flexible to pivot in approach
• Uses strong attention to detail, advanced problem-solving, and complex reasoning to effectively produce change and demonstrate impact
• 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 open 7 days a week, with 13 convenient locations and 16 practices in Greensboro, Winston-Salem, High Point, Kernersville, Jamestown, North Wilkesboro, and Mt. Airy, North Carolina. We have grown to provide facilities, staff, and support to offer urgent care, primary care, diagnostic testing, outpatient ancillary, and specialty care services onsite. Bethany Medical Center is staffed with board-certified physicians and providers representing over 16 medical specialties. Our practice staff members are known for treating each patient with prompt, personalized care and attention. Bethany Medical employs over 60 providers and over 520 employees.

About the Triad

The Triad area includes Greensboro (the 3rd 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 the traffic, including the Piedmont Triad International Airport in Greensboro with convenient non-stop flights to most major cities. Enjoy an outstanding quality of life with no shortage of arts, entertainment, recreation, shopping, and hundreds of restaurants. The Triad is home to 85 colleges and universities, including Wake Forest University, High Point University, UNC-Greensboro, NC A&T, Guilford College, Bennett College, and Greensboro College.