Insurance Incentive Coordinator

Canton, NY ( NY USA 13617)

Job Type

Full-time

Description

REPORTS TO : Director of Quality Assurance & Corporate Compliance

PAY RATE : $19.85 per hour; biweekly pay structure

WORK SCHEDULE : Full-time; 37.5 hours per week; Weekdays only, no nights, no weekends, no major holidays

POSITION SUMMARY : This position will play a pivotal role in optimizing value-based care metrics by collaborating with insurance companies.

The primary responsibility of this position will be to ensure that the FQHC meets and exceeds performance expectations related to value-based care initiatives.

This position will work closely with internal teams, insurance providers, and other stakeholders to coordinate and implement strategies that enhance healthcare outcomes while maximizing incentives.

PRIMARY RESPONSIBILITIES :

1.Collaboration with Insurance Companies :

a) Build and maintain positive relationships with insurance companies to facilitate effective communication and collaboration.

b) Stay informed about insurance providers' policies, procedures, and specific requirements related to value-based care metrics.

2.Performance Monitoring :

a) Develop and implement methods for monitoring and analyzing value-based care metrics to identify areas for improvement.

b) Regularly review performance data to ensure that the FQHC is meeting or exceeding benchmarks set by insurance companies.

a) Collect, analyze, and interpret data related to value-based care initiatives.

b) Prepare and present comprehensive reports to internal teams and insurance partners, highlighting achievements and areas for improvement.

4.Incentive Maximization :

a) Identify opportunities for maximizing incentives through strategic initiatives and process improvements.

b) Work with internal stakeholders to implement changes that positively impact value-based care outcomes and financial incentives.

5.Educational Initiatives :

a) Develop and deliver training programs to internal staff on value-based care concepts and the importance of meeting metrics.

b) Provide ongoing education to healthcare providers and support staff to ensure alignment with insurance company requirements.

6.Policy Compliance :

a) Stay up-to-date with industry regulations and policy changes affecting value-based care and insurance incentives.

b) Ensure the FQHC's practices align with regulatory requirements and contractual obligations.

7.Cross-Functional Collaboration :

a) Collaborate with various departments, including clinical, finance, and quality improvement teams, to achieve common goals related to value-based care.

Requirements

Associate degree in Healthcare Administration, Business, or a related fieldrequired. Bachelor's degree preferred.

One year prior experience working in a healthcare setting isrequired; knowledge of Federally Qualified Health Centers (FQHCs) is preferred.

Strong understanding of value-based care models and metrics.

Excellent communication, negotiation, and interpersonal skills.

Proficiency in data analysis and reporting tools.

Knowledge of healthcare regulations and insurance industry standards.

Ability to work collaboratively in a team-oriented environment.

Must have a valid NYS Driver’s License and ability to travel between sites.

BENEFITS :

Cerebral Palsy Association / Community Health Center of the North Country offers eligible employees excellent, affordable benefits options.

Options include medical, dental, and vision insurance, Flexible Spending Account (FSA), Term Life / AD&D insurance, long-term and short-term disability, 401(k), and other elective programs.

We also offer generous time off, including vacation, personal, and sick time, as well as paid holidays.

Salary Description

$19.85 per hour; biweekly pay structure

Last updated : 2024-03-22