Note: The job is a remote job and is open to candidates in USA. Curana Health is a national leader in value-based care serving older adults through solutions including on-site primary care services, Accountable Care Organizations, and Medicare Advantage Special Needs Plans. The Manager, Value-Based Care Operations supports quality initiatives, operational processes, compliance activities, reporting functions, and data management across ACO programs while coordinating with providers, vendors, healthcare organizations, and internal stakeholders.
Responsibilities
- Coordinate and monitor EMR and quality report delivery, ensuring timely distribution and follow-up on outstanding items
- Educate ACO participating group operators and providers on quality measures, performance metrics, and reporting expectations
- Research and resolve quality reporting gaps while collaborating with affiliate back-office teams to improve data accuracy
- Compile and validate Social Determinants of Health (SDOH) data for regulatory and program reporting requirements
- Support Promoting Interoperability (PI) communications and follow-up activities
- Pull, analyze, and distribute monthly reports from electronic medical record systems
- Review, compile, and verify monthly quality and performance reporting packages before distribution
- Ensure billing bifurcation reports are delivered accurately and on schedule
- Collaborate with EMR vendors and external teams to investigate and resolve reporting discrepancies
- Communicate effectively with stakeholders regarding reporting issues, corrections, and status updates
- Maintain and update the ACO Operations Manual, ensuring procedures and workflows remain current and compliant
- Identify, document, and implement new operational processes as organizational needs evolve
- Coordinate stakeholder input and support process improvements across multiple workstreams
- Audit, maintain, and manage Specialty Building tracking processes and associated databases
- Support operational activities, including preparing external-facing materials and coordinating timely, secure data submissions through designated SFTP processes
- Review monthly invoices and volume reports for accuracy and provide recommendations for approval
- Coordinate recurring compliance activities, including submission of vendor, TIN, and board member listings
- Support reporting and documentation requirements to ensure compliance with organizational and regulatory standards
- Serve as a trusted point of contact for ACO participating groups, providers, and vendors
- Build strong working relationships through responsive communication, professionalism, and proactive problem-solving
- Deliver exceptional customer service while balancing multiple priorities and stakeholder needs
- Facilitate collaboration across departments to support operational excellence and the successful implementation of initiatives
Skills
- * Bachelor's degree in Healthcare Administration, Business Administration, Public Health, Health Information Management, or related field
- * 3–5 years of experience in healthcare operations, quality reporting, healthcare analytics, population health, value-based care, or a similar healthcare environment
- * Advanced Microsoft Excel skills, including experience working with large datasets, Pivot Tables, XLOOKUP/VLOOKUP, data validation, reconciliation, trend analysis, reporting, and data analysis
- * Hands-on experience working with EMR/EHR systems and healthcare reporting data
- * Experience analyzing, validating, and distributing operational and quality reports
- * Experience working directly with external affiliates, providers, vendors, and internal stakeholders
- * Proven experience managing multiple projects, priorities, and deadlines in a fast-paced environment
- * Strong analytical, problem-solving, critical thinking, written communication, and verbal communication skills
- * Exceptional organizational skills and attention to detail
- * Ability to build and maintain productive relationships with providers, affiliates, vendors, and cross-functional stakeholders
- * Strong customer service orientation and the ability to effectively manage stakeholder expectations
- * Familiarity with CMS quality and reporting programs, including:
- + Merit-based Incentive Payment System (MIPS)
- + Promoting Interoperability (PI)
- + Social Determinants of Health (SDOH)
- * Knowledge of healthcare quality metrics, provider performance measurement, and regulatory reporting requirements
- * Understanding of operational process improvement and workflow optimization within healthcare environments
- * Experience supporting Accountable Care Organizations (ACOs), Medicare Shared Savings Program (MSSP), population health, or value-based care programs
- * Experience supporting healthcare quality improvement initiatives and provider performance programs
- * Experience collaborating with EMR vendors and external healthcare organizations
Company Overview
Company H1B Sponsorship