As a member of the Payer Operations team, the Manager, Medicare Operations will be a key team member that has deep experience with Medicare programs. The Associate will support, guide & coordinate operational processes associated with governmental programs including traditional medicare & direct contracting programs
This position will report to the Director of Payer Operations. We are open to considering candidates who reside in Massachusetts or North Carolina.
This is an exciting opportunity for someone looking to play a key role in a high growth, innovative healthcare company.
- Serves as the subject matter expert for new & existing traditional medicare & CMS Direct Contracting requirements, & ensures that appropriate operational plans are put in place to meet those requirements
- Acts as the primary point of intake for Medicare questions & requests
- Creates, updates & maintains standard operating procedures, work instructions, & policies & procedures to support medicare work
- Identifies, develops & owns reports needed to support medicare programs
- Responsible for overseeing ongoing operational duties to support these programs (rosters, alignment forms, etc.)
- Identifies opportunities for process improvement & proposes efficient remedies to improve operational processes
- Works cross functionally to ensure key stakeholders are informed & consulted with relative information as appropriate
- Maintain professional & productive relationships with key internal & external stakeholders
The successful candidate will:
- Be an effective project manager with the ability to plan, organize & execute plans with rigor
- Have deep knowledge with Medicare ACO/MSSP programs plans including Direct Contracting
- Be empathetic & an excellent listener; able to engage with internal & external stakeholders in a collaborative & positive manner. Excels working in a team based environment
- Identify areas of opportunity & be committed to implement refinement opportunities to continue to meet the needs of all stakeholders
- Uncomfortable with the status quo; a creative thinker & excellent problem solver & comfortable working independently
- A clear communicator who is able to synthesize & tailor communication to different audiences both verbally & in writing
- Detailed-oriented; demand & deliver high quality work products
- Comfortable with a high degree of ambiguity, rapid change; an experimenter by nature
- Has a background in & passion for research, both qualitative & quantitative
- Bachelors degree in business, healthcare or a related field
- Minimum of one year of experience with a ACO, health plan, or health system organization working directly with Medicare programs ACO/MSSP programs
- 3+ years of Medicare ACO/MSSP (Medicare shared savings program) experience
About Iora Health
Iora Health is transforming health care, starting with primary care. We created a high-impact relationship based care model, that particularly benefits adults on Medicare & those who might need more attention. Our care model changes everything - the team, outcome-focused payment, customer service, & the technology that supports our care.
We know that when you invest in relationships with people, you can help them live happier & healthier. Our patients get a team that respects & listens to them. We get paid to keep our patients healthier, & it works - we are successfully improving the lives of our patients while lowering costs.