UnityPoint Health ACO Finance Specialist in West Des Moines, Iowa
ACO Finance Specialist position will be tasked with building tools, reporting and incentive models that guide behaviors in response to changing healthcare activities to produce greater value. There will be extensive interface with payor strategy, risk analytics and finance to model opportunities and impact of the clinical and operational efforts of the clinically integrated network of our Accountable Care Organization that link to business strategy and ultimately influence the adoption of new ideas, products and approaches. Success in this career relies on the ability to translate highly complex concepts to a variety of audiences, deal with ambiguity, adapt and embrace change, and a long term commitment to enhance the healthcare delivery model.
ACO Financial Accounting and Analysis
Develop and monitor the shared risk (savings or loss) budget based on projected performance of value-based arrangements within the Accountable Care Organization.
Understand value-based arrangements financial terms, past performance (if any), model used to project savings or loss and UPH financial management system.
Finalize each value-based arrangement’s annual savings or loss and distribute across the clinically integrated network.
Demonstrate understanding of the current funds flow model, application of a value-based arrangement financial terms within the funds flow model, and the participating ACO provider network by accurately calculating or validating the savings or loss allocations by ACO participating provider.
Demonstrates an appropriate understanding of the regulatory environment and applies that understanding to on-going responsibilities. This requires extensive review of potential overlap programs and their impact on savings and loss payments at the system, network and provider levels
Assist in the development of the ACO budget and reconcile on a monthly basis. This requires appropriate use of the current budget software, Stratajazz, and a knowledge of the UPH financial accounting system.
Responsible for providing data or independently extracting to analyze network clinical trends, measure network outcomes and facilitate communication with the provider network team to ensure interventions developed to improve care are timely, measurable and effective.
Value Based Arrangement Management
Identify and design the right incentive measures and models to drive improved levels of integration, provider engagement, encourage appropriate use of evidence-based standards of quality, and ultimately enhance performance in value based arrangement.
Assist in modeling of various pay-out and gainsharing arrangements in all ACO models.
Assist in development of tracking systems for appropriate capitation payments and sub-capitation payments
Track and evaluate all PMPM payments from payors to the clinical delivery and assess the ROI
Guide analytics and care coordination team to evaluate the FFS payments of care coordination codes applied to beneficiaries and members in order determine total ROI, including cost savings achieved, reimbursement gained, and enterprise value achieved.
Directs cross-functional teams to meet the objectives the value-based arrangement with the Accountable Care Organization – these include but are not limited to revenue cycle, EPIC IT, Performance improvement
- Bachelor’s degree required.
General finance experience.
5+ years of experience in operational, problem solving, product development and consensus building roles.
Healthcare or health insurance experience preferred.
Skills and Knowledge:
Strong analytical skills.
An understanding of general accounting principles.
Ability to influence peers and leadership across a matrix organization
Ability to identify, analyze and present solutions to solve problems in a complex environment.
Process-oriented with strong organization and planning skills.
Proficiency with computer applications with a strong emphasis on database and spreadsheet applications.
Requires highly developed communication skills to effectively work with all levels of management.
Requisition ID: 2020-76664
Street: 1776 West Lakes Pkwy
Name: Finance & Network Dev
FTE (Numeric Only; Ex. 0.01): 1.0
FLSA Status: Exempt
Scheduled Hours/Shift: Days
External Company Name: UnityPoint Health
External Company URL: http://www.unitypoint.org