Sr. Manager, ACO Quality Operations

Posted 14 Days Ago
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Hiring Remotely in USA
Remote
Senior level
Healthtech
The Role
The Sr. Manager, ACO Quality Operations oversees ACO Quality Reporting processes, ensuring compliance with regulations, managing data submission, and collaborating with teams for performance improvements while providing subject matter expertise in Quality Payment Program reporting.
Summary Generated by Built In

About Our Company

Vytalize Health is a leading value-based care platform. It helps independent physicians and practices stay ahead in a rapidly changing healthcare system by strengthening relationships with their patients through data-driven, holistic, and personalized care. Vytalize provides an all-in-one solution, including value-based incentives, smart technology, and a virtual clinic that enables independent practices to succeed in value-based care arrangements. Vytalize's care delivery model transforms the healthcare experience for more than 250,000+ Medicare beneficiaries across 36 states by helping them manage their chronic conditions in collaboration with their doctors.


About our Growth 

Vytalize Health has grown its patient base over 100% year-over-year and is now partnered with over 1,000 providers across 36-states. Our all-in-one, vertically integrated solution for value-based care delivery is responsible for $2 billion in medical spending. We are expanding into new markets while increasing the concentration of practices in existing ones.

Visit www.vytalizehealth.com for more information.


Why you will love working here

We are an employee first, mission driven company that cares deeply about solving challenges in the healthcare space. We are open, collaborative and want to enhance how physicians interact with, and treat their patients. Our rapid growth means that we value working together as a team. You will be recognized and appreciated for your curiosity, tenacity and ability to challenge the status quo; approaching problems with an optimistic attitude. We are a diverse team of physicians, technologists, MBAs, nurses, and operators. You will be making a massive impact on people’s lives and ultimately feel like you are doing your best work here at Vytalize.

Your Opportunity 

The Sr. Manager, ACO Quality Operations is responsible for overseeing and ensuring the proper completion and compliance of ACO Quality Reporting procedures, including MSSP and REACH ACOs. This role serves as the subject matter expert (SME) for ACO Quality Reporting processes, including the Quality Payment Program (MIPS) and other related reporting requirements. The Sr. Manager will manage data collection and submission, collaborate with cross-functional teams to drive performance improvements, and maintain compliance with CMS regulations. The Sr. Manager will create education opportunities and content to enhance the knowledge of internal and external customers as it relates to ACO Quality reporting, Quality Payment Program (MIPS), and applicable topics.

What you will do

  • Lead ACO Quality Reporting: Ensure timely and accurate reporting for MSSP, REACH. This includes oversight of GPRO, eCQMs, Medicare CQMs, and other applicable measures. 
  • Subject Matter Expertise: Provide expert knowledge on MSSP, REACH, and Quality Payment Program (MIPS) reporting. Explain program differences and maintain updated knowledge on quality reporting content and annual changes. 
  • Data Collection and Submission: Coordinate and support the required processes to ensure timely data collection, validation, and submission of quality measures, including CAHPS registration and contracting for MSSP and REACH. 
  • Performance Monitoring and Improvement: Lead initiatives to track and enhance quality performance, ensuring compliance with CMS guidelines and improving ACO performance across measures.  
  • Create Educational Content: Develop and deliver education materials and training to internal and external stakeholders, enhancing their understanding of ACO Quality Reporting and Quality Payment Program topics. 
  • Collaborate Across Teams: Work closely with data analytics, performance teams, and external vendors to ensure efficient data collection, reporting, and performance monitoring processes. Identify workflow gaps and recommend solutions for improvement. 
  • Compliance and CMS Guidance: Stay informed on CMS guidance and reporting updates available through ACOMS, 4i, QPP, and other partners to inform decision-making and action plans. Communicate with internal compliance team members and CMS Help Desks as needed to clarify regulations. 
  • Project Management: Coordinate all necessary processes, resources, and tools to meet CMS reporting deadlines, managing staff and external resources to ensure project success. 

What you will need 

  • Bachelor's degree in Healthcare Administration, Public Health, Nursing, or a related field (Master's preferred). 
  • Minimum of 5 years of experience in healthcare quality reporting and administration. 
  • Proven experience leading and managing MSSP Quality Reporting, GPRO data collection, and electronic quality reporting 
  • Creating and delivering education to internal and external stakeholders about ACO Quality 
  • Relevant healthcare quality certification (e.g., CPHQ, RHIA, or equivalent) is preferred 
  • In-depth understanding of CMS regulations, MSSP, and ACO quality reporting requirements. 
  • Proficiency in electronic quality reporting workflows. 
  • Excellent communication skills, both written and verbal. 

This role requires a high level of attention to detail and the ability to manage multiple priorities in a fast-paced environment. 


Benefits

  • Competitive base compensation 
  • Annual bonus potential 
  • Health benefits effective on start date; 100% coverage for base plan, up to 90% coverage on all other plans for individuals and families  
  • Health & Wellness Program; up to $300 per quarter for your overall well-being available on start date  
  • 401K plan effective on the first of the month after your start date; 100% of up to 4% of your annual salary 
  • Unlimited (or generous) paid "Vytal Time", and 5 paid sick days after your first 90 days 
  • Company paid STD/LTD 
  • Technology setup  
  • Ability to help build a market leader in value-based healthcare at a rapidly growing organization  

Please note at no time during our screening, interview, or selection process do we ask for additional personal information (beyond your resume) or account/financial information.  We will also never ask for you to purchase anything; nor will we ever interview you via text message. Any communication received from a Vytalize Health recruiter during your screening, interviewing, or selection process will come from an email ending in @vytalizehealth.com


The Company
HQ: Hoboken, NJ
148 Employees
On-site Workplace
Year Founded: 2014

What We Do

Vytalize Health is a leading value-based care platform. It helps independent physicians and practices stay ahead in a rapidly changing healthcare system by strengthening relationships with their patients through data-driven, holistic, and personalized care. Vytalize provides an all-in-one solution including value-based incentives, smart technology, and a virtual clinic that enables independent practices to succeed in value-based care arrangements. Vytalize's care delivery model transforms the healthcare experience for more than 200,000 Medicare beneficiaries across 30 states by helping them manage their chronic conditions in collaboration with their doctors.

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