AmeriHealth Caritas Jobs

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AmeriHealth Caritas Value Based Contracting Analyst in Raleigh, North Carolina

Value Based Contracting Analyst

Location: Raleigh, NC

Primary Job Function: Provider Network

ID**: 21286

Your career starts now. We’re looking for the next generation of health care leaders.

At AmeriHealth Caritas, we’re passionate about helping people get care, stay well and build healthy communities. As one of the nation's leaders in health care solutions, we offer our associates the opportunity to impact the lives of millions of people through our national footprint of products, services and award-winning programs. AmeriHealth Caritas is seeking talented, passionate individuals to join our team. Together we can build healthier communities. If you want to make a difference, we’d like to hear from you.

Headquartered in Philadelphia, AmeriHealth Caritas is a mission-driven organization with more than 30 years of experience. We deliver comprehensive, outcomes-driven care to those who need it most. We offer integrated managed care products, pharmaceutical benefit management and specialty pharmacy services, behavioral health services, and other administrative services. Discover more about us at www.amerihealthcaritas.com .

Responsibilities:

The primary purpose of the job is to work closely with Provider Network Management, including the Practice Transformation support team and other Plan functional area management/leaders to develop reports to monitor pertinent areas of performance, such as, but not limited to Provider Network Management (PNM) contracts and programs including Value Based (VB) Contracting market share and programmatic impacts. Tracks and trends key indicators for PNM and other impacted functional areas and utilizes data to support, monitor and provide direction as requested and required by related functional area. Collaborate with IS and Medical Informatics to create and establish data collection and data sharing reports and monitor effectiveness of specific initiatives as appropriate in areas assigned. Examples include quality outcome driven programs, health promotions and population health programming like Patient Centered Medical Homes (PCMH); Advanced Medical Homes (AMH), Quality Enhancement Program (QEP) and corresponding VB initiatives and associated data, i.e. ER utilization, wellness programs, care management, member and provider support programs, outreach productivity and action plans for continuous performance improvement. Collaborates with a variety of corporate departments including Provider Network Management, , Medical Informatics, Quality, Legal, and Compliance, as well as Plan staff and providers within the Plan network in assessing data needs and evaluating /implementing data solutions May also develop ad-hoc reports for Plan Market President and Provider Network Management/Practice Transformation support teams.

Education/ Experience:

  • Associate’s Degree

  • Bachelor’s Degree (Preferred).

  • Or equivalent combination of education and experience.

  • 1 to 3 years experience in a position with similar level of responsibility and complexity.

Other Skills:

  • Proficient in Excel and ACCESS, Word, Crystal Reports and Bi-Query.

  • Proven ability to learn new applications used for reporting.

  • Demonstrated ability to interface with all levels of management.

  • Demonstrated meeting facilitation skills.

  • Ability to analyze business area’s reporting needs and method of reporting to be used.

  • Proficient in examining and analyzing data from a reporting and data analysis perspective.

  • Demonstrated use and knowledge of databases and integration of new systems.

  • Strong problem solving, analytical, organizational, and research skills.

  • Demonstrated technical and project management skills with the ability to coordinate and manage multiple concurrent projects and delegate responsibility.

EOE Minorities/Females/Protected Veterans/Disabled

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