Careers

Below you’ll find all of the open positions currently available with the PA Clinical Network. If you’re interested in exploring any of the roles listed, please forward a resume with a cover letter to the email and/or physical address listed. Please send it “in care of” the appropriate department. Thank you for your interest. 

Clinical Transformation Consultant

Status:                   

Full Time

Reports To:            

Senior Director of Clinical Outcomes & Quality

Location:              

400 Winding Creek Boulevard, Mechanicsburg, PA 17050        

 

Issue Date:

October 8, 2021

 

Position Summary:

The Care Centered Collaborative (CCC) and its functional subsidiary, the PA Clinical Network (PACN), were created by the Pennsylvania Medical Society to empower physicians to lead and thrive as healthcare payment models evolve.  The PACN promotes and enables value-based care arrangements and contracting that support and sustain physician-led practices in Pennsylvania with actionable information to improve individual and community care.

The Clinical Transformation Consultant (CTC) will be a key contributor to the successful execution of the critical functions needed to support the PACN and its value-based contracts. This job is a highly skilled subject matter expert (SME) in Medicare STARS, HEDIS and risk revenue streams and provides strategic, hands-on, office-based support to providers and their inter-departmental teams for transformation of workflows resulting in outstanding performance. This position will focus on supporting the value strategy for each practice and overall operational functions of the PACN.  Billing and coding experience or willingness to learn hierarchical coding requirements is highly desired.

 

Essential Duties and Responsibilities:

  • Build and maintain working relationships with physicians, providers, and staff of the PA Clinical Network (PACN), providing on-going guidance and support related to quality improvement and clinical practice improvement opportunities.

 

  • Work closely with the Directors of Clinical Outcomes and other members of the CCC team to implement clinical improvement strategies that will enable physicians/providers to succeed in value-based reimbursement.

 

  • Demonstrate an ability to connect with practicing providers and staff, build and manage relationships and establish bi-directional communication between network members and the Care Centered Collaborative.

 

  • Directly responsible to provide office based, hands-on assistance services to practices enrolled in PACN value-based programs. The CTC is expected to assess the needs of each individual practice, and use a combination of on-site individual office based, video conference, teleconference, and electronic mail interactions to drive engagement and compliance.

 

  • Identify targeted clinical opportunities for performance improvement and gap closure.

 

  • Participate in the development and presentation of instructional materials for internal and external stakeholders.

 

  • Assist providers and staff in the use of user interfaces and the population health platform used by the PACN and its member practices.

 

  • Understand current organization priorities and objectives.

 

  • Communicate and educate PACN physicians, providers, and staff regarding clinical guidelines, protocols and standards related to quality and utilization process with the aim of supporting the PA Clinical network value-based contracts.

 

  • Act as a liaison within the CCC and all assigned PACN practices.

 

  • Support quality improvement goals directed at improving the PACN performance and its established business strategies.

 

  • Keep current with accepted standards and professional developments in the areas of quality improvement, population health and utilization management.

 

  • Assist in carrying out the strategic plan for the PACN. Efficiently work with internal and external stakeholders to achieve the performance targets and goals identified by senior leadership and associated physician committees.

 

  • Carry out approved quality-related interventions to maximize incentive earnings for each value-based contract.

 

  • Serve as the clinical subject matter expert for PACN member practices for quality improvement initiatives.

 

  • Assist in the development of training materials and written procedures that optimize workflows and drive care strategies and network performance.

 

  • Attend and participate in essential operational and organizational meetings.

 

  • Educate PACN team and practices on hierarchical coding processes.

 

 

Knowledge:

Understanding of health care industry trends including clinically integrated networks and value-based reimbursement programs.  Familiarity with HEDIS/STARS and NCQA quality standards.  Experience working with Medicaid and/or Medicare. Billing and coding experience a plus or willingness to learn hierarchical coding processes.

 

Skills and Abilities:

Excellent written and verbal communication skills. Demonstrate ability to work effectively with internal and external stakeholders. Possess strong analytical and organizational skills. Demonstrated leadership skills and experience with ability to multi-task and think independently. Flexibility and adaptability to shifting payer priorities and variable practice quality performances.

 

Proficiency in software applications that include, but are not limited to, Microsoft Word, Microsoft Excel, Microsoft Power Point.

 

Experience:

Clinically trained and/or demonstrates experience working in outpatient clinical settings.  Experience presenting to physicians and healthcare leadership. Three to five years of experience in health care consulting, managed care – especially specific to provider network or population health management and/or value-based reimbursement programs.

 

Education, Certification and Licenses:

Bachelor’s Degree required.

 

Work Environment:

The individual in this role must have strong inter-personal skills, be organized, self-directed, flexible, and enthusiastically represent the Care Centered Collaborative and its mission and goals.

 

Travel Requirements:

Travel to physician practices in Pennsylvania approximately 50% of the time. Additional travel to Harrisburg for Network and Team meetings may be required.

 

Physical Demands:

While performing the duties of the job, the employee is frequently required to sit, use hands and fingers, talk, hear, and see. Must occasionally lift and/or move objects weighing up to 5 pounds. The employee must have a car and the ability to drive to numerous practice locations. The employee must be able to work over 40 hours per week.

 

Key Interface:

Works collaboratively with business resources in key internal and external stakeholder areas.

 

Number of Direct and Indirect Reports:

None

 

The incumbent shall perform all other functions and/or be cross trained as shall be determined by the sole discretion of management, who has the right to amend, modify, or terminate this job in part or in whole. This document is not a contract for employment.  Employment is at-will.

 

 

 

Signatures/Approval

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Employee:

 

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Date:

 

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Manager/Supervisor:

 

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HR Compensation:

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The Pennsylvania Medical Society, Care Centered Collaborative, and PA Clinical Network embrace diversity and equal opportunity in a serious way. We are committed to building a team that represents a variety of backgrounds, perspectives, and skills. All qualified applicants will receive consideration for employment without regard to their age, race, color, religion, sex, national origin, sexual orientation, protected veteran status, or disability. The more inclusive we are, the better our work will be.

 

717-803-8063 400 Winding Creek Boulevard, Mechanicsburg, PA 17050      patientccc.com

Chief Operating Officer

Description of The Care Centered Collaborative and PA Clinical Network

The Collaborative (CCC) and the PA Clinical Network (PACN) are wholly owned subsidiaries of the Pennsylvania Medical Society. The Collaborative was created in 2016 by the Pennsylvania Medical Society (PAMED) to enable Pennsylvania physicians to lead and thrive as healthcare payment models evolve.  The CCC promotes and enables value-based care arrangements and contracting that support and sustain physician-led practices in Pennsylvania with actionable information. The Collaborative’s tools, resources, and expertise are actively being deployed through the PA Clinical Network to help Pennsylvania physicians in diverse practice settings achieve the highest levels of patient-centered outcomes regardless of practice size, location, or electronic health record.

 

Job Location

  • This is primarily a work-from-home position, with required in-person meetings in Harrisburg, PA.
  • Full-time salaried position
  • Moderate travel will be required including travel outside the state for conferences.
  • Occasional evening and weekend hours may be required.

 

Position Description

Understanding and managing patients’ experience of care, clinical status, and economic outcomes are core to the mission of the PA Clinical Network. The Chief Operating Officer (COO) brings strategic vision as well as a tactical, experienced, and hands-on ability to transform clinical and financial data into actionable goals that will benefit Network patients, participating physicians, and the Pennsylvania Medical Society. The COO consistently keeps up to date with evolving benchmarks used by payers and buyers to assess value in support of the Network. This individual also brings customer-focused and team-based problem-solving skills to assure the timely and on-budget implementation of any insourced or outsourced projects to assure the success of value-maximizing initiatives across the enterprise. Outstanding communication, trustworthiness, and interpersonal “people skills” at all levels of the organization are key attributes that will facilitate buy-in and support from all stakeholders.

 

Qualifications for the Position

  • Master’s degree or professional licensure designation in a business related field is required.
  • Minimum of five years of insurer, payer, employer, or government experience in healthcare payments, utilization, cost management, actuarial projections, or economics.
  • Experience in the management, support of healthcare information systems and information technology vendors is desirable.
  • Significant experience in multiple clinical healthcare settings is highly desirable.
  • Demonstrated proficiency in various computer software programs including the Microsoft Office suite of programs.   
  • Valid driver’s license.

 

Additional skills needed for a successful Chief Operating Officer include:

  • Ability to motivate, organize, and respond to employees of many different areas of expertise
  • Excellent business and budget-planning skills
  • Strong organizational and time-management skills
  • Ability to adapt to changing environments
  • Excellent verbal and written communication skills
  • Excellent interpersonal and relationship-building skills
  • Ability to work as an independent contributor and as part of a team

Duties of the position will include:

  • Work with the Chief Executive Officer (CEO) to set and drive the organizational vision and mission, corporate strategy, and hiring needs.
  • Oversee daily company operations, project timelines, business developments, and employee productivity while building a highly inclusive culture to ensure team members thrive. 
  • Track progress toward goals of contracts, internal benchmarks, key performance indicators and the financial impact.
  • Develop actionable business strategies, budgets, financial statements and data analyses, objectives, and plans that ensure alignment with short and long term objectives developed in tandem with the CEO. 
  • Optimize business growth and revenue strategy to meet the expectations of the CCC, PACN, buyers, payers, and other stakeholders.
  • Implement financial procedures and organizational policies and programs to drive the company’s operating capabilities.
  • Oversee and support Accountant in reporting enterprise financial performance, meeting any audit requirements, assuring accurate contract payment fulfillment, and strategic planning.
    • Produce regular fiscal and corporate dashboard reports to meet the transparency requirements of the corporation and the shareholder parent organization.
  • Oversee statistical analyses and assure team-based accountability in data analytics. 
  • Model the return on investment of existing and potential insurance contracts in Medicaid, Medicare, Commercial, and Administrative Service Plans on a provider, clinic, regional, and product-line basis.
    • Monitor and report monthly, and quarterly return on investment of existing insurance contracts on an accrual and realized basis.
  • Supervise Information Technology (IT) Directors and their data entry, imports/exports, storage, back-up integrity, and manipulation.
    • Oversee data security and compliance programs as Security Officer for the CCC and subsidiaries.
      • Advocate, enforce, and update policies/procedures for information data management
    • Monitor advancements in the quality and cost of information technology and champion their adoption in support of the PACN and CCC business objectives. 

Duties unique to the CCC and PACN:

  • Attend and present as needed to the parent, company, and subsidiary boards of directors, and any of the Pennsylvania Medical Society’s constituent organizations.
  • Attend payer-Network operating committee meetings and often serve as the company spokesperson in payer interactions.
    • Maintain deep familiarity with contract terms and serves as first point-of-contract with payers on an ongoing basis to monitor contract success.
  • Staff the PACN Funds Flow and Contracting Committees and support their Chairs.
    • Develop provider payment policies, proposals, and algorithms in collaboration with PACN management and Committee leadership.
  • Coordinate the development of all internal patient satisfaction, HEDIS, STARS, utilization, and cost benchmarks in collaboration with the Senior Quality Director.

EEO Statement

The PA Medical Society, The CCC and the PACN embrace diversity and equal opportunity in a serious way. We are committed to building a team that represents a variety of backgrounds, perspectives, and skills. The more inclusive we are, the better our work will be.

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Clinical Transformation Consultant

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Chief Operating Officer