5+ years' experience of successful healthcare industry sales, customer support or clinical support, with strong preference for network development, value-based or risk-based provider contracting and/or pharmaceutical or medical device sales experience with results.
Excellent verbal and written communication and relationship skills.
Demonstrated ability to develop relationships and positively influence providers resulting in attainment of network growth goals.
Familiarity with alternate payment models including fee for service, capitation, global budget, pay for performance, episodes of care, cost/quality targets, etc.
Excellent problem-solving skills, including ability to systematically analyze problems and draw conclusions and devise appropriate course of action
Strong computer skills with understanding of internet and experience in healthcare database management/report creation
Works with the network growth team, communicating and coordinating with all Chamber team members as appropriate.
Drives all phases of practice recruitment and is responsible for contracting including creating/managing recruitment pipeline, contract preparation, telephonic outreach, follow up with providers and securing executed contracts.
Responsible for Network maintenance, relationships, on-boarding, and training for network partners.
Develops a plan for consistent interaction and support of existing Network providers and practices.
Develops a comprehensive provider network to meet market and payer needs.
Provides strategic input on contracting needs and network adequacy.
Works cross-functionally with other individuals to remove barriers impeding converting practice targets, contract implementation, identify opportunities for improvement and facilitates problem resolution.
Responsible for accurate provider database documentation, and maintenance of provider information.
Candidate must be a licensed NP (cardiac certification is highly desired)
Real world cardiology patient care experience – whether in a hospital setting or a cardiology practice – is a must
Interest in a fast paced, entrepreneurial environment
Conduct thorough assessments and evaluations of patients with cardiovascular conditions, including hypertension, coronary artery disease, heart failure, atrial fibrillation, and other chronic heart diseases.
In partnership with the Chief Medical Officer and cardiology practices, develop and implement individualized care plans that emphasize prevention, early intervention, and optimal management of cardiac conditions within the value-based care model.
Monitor and manage medication regimens, ensuring medication adherence and adjusting treatment plans based on patient progress and evidence-based guidelines.
Actively manage high-risk patients, including those with multiple co-morbidities, to prevent hospital readmissions and improve long-term health outcomes.
Use remote patient monitoring tools and telemedicine to track patient progress, intervene early in cases of deterioration, and reduce unnecessary hospital visits.
Collaborate with primary care providers, cardiologists, specialists, and care teams to ensure seamless care delivery and align interventions with the goals of value-based care contracts.
Facilitate timely follow-up appointments, ensuring that care is delivered in the most efficient setting (in-office, telehealth, home visits, etc.) to improve outcomes and reduce costs.
Engage in shared decision-making with patients to align treatment plans with their preferences, values, and goals while maximizing quality of life.
Engage with hospital and health plan transitions of care programs to support patients post discharge.
Provide patient and family education regarding cardiovascular disease management, prevention strategies, medication adherence, lifestyle changes (diet, exercise, smoking cessation), and self-management techniques.
Empower patients to take an active role in managing their health through disease education, self-monitoring, and adherence to prescribed interventions.
Implement remote patient engagement tools (e.g., patient portals, mobile health apps) to promote self-management and improve patient engagement.
Focus on achieving key quality metrics outlined in the value-based care program, such as reducing hospital readmissions, improving medication adherence, lowering emergency department utilization, and enhancing patient satisfaction.
Participate in the development and implementation of evidence-based protocols and care pathways designed to improve quality of care while reducing unnecessary healthcare utilization and costs.
Collect and analyze patient data to identify trends and outcomes, making recommendations for process improvements to enhance care delivery and performance against value-based care targets.
Ensure accurate and timely documentation in the electronic health record (EHR) in compliance with legal, regulatory, and company requirements.
Utilize data from EHR systems to track patient outcomes, quality measures, and other value-based care performance indicators.
Maintain certifications and stay informed about the latest clinical guidelines, regulatory changes, and value-based care initiatives.
Actively participate in interdisciplinary team meetings, case reviews, and quality improvement initiatives focused on improving patient care, reducing costs, and meeting value-based care goals.
Contribute to the development of new programs or workflows that promote efficient, high-quality, and patient-centered care.
Mentor and provide guidance to other healthcare providers, including nurses, medical assistants, and care coordinators, in supporting the goals of value-based care.