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Hill Physicians Medical Group · 23 hours ago

Senior Program Specialist

San Ramon, CA

Full-time

Onsite

Senior Level

$120K/yr - $140K/yr

5+ years exp

Hill Physicians Medical Group is shaping the healthcare of the future with actively managed care. The Senior Program Specialist will develop and grow health plan relationships to support PPO strategies, focusing on improving care quality and patient satisfaction while managing cross-functional collaborations.

Health CareMedicalProfessional Services

Hiring Manager

Michelle Peck

Responsibilities

Coordinate performance reporting and communications with our health plan partners and with senior leadership to ensure progression toward our clinical, financial, and operational goals for the PPO program

Define the agenda and coordinate content across several departments for recurring external meetings and steering committees with each partner health plan

Execute and delegate action items with our health plan partners across various Hill departments and meet 1:1 with health plans to ensure progress between committee meetings

Summarize and present the PPO Program’s recent achievements, performance, and challenges to senior leadership and health plan partners

Support the evaluation and negotiation of new value-based payments arrangements and amendments proposed by health plans

Review health plan contracts to understand each partner’s unique ACO arrangement

Maintain summaries of health plan ACO program terms and performance

Coordinate and summarize cross-functional reviews by clinical, analytic, and operational teams of proposed terms, and model the summary financial impact of proposed contract terms

Enhance current PPO initiatives and guide the development of new and existing interventions using health plan-provided data and reporting

Identify trends and opportunities using different reports from the health plan

Validate internal reporting against health plan-provided reporting

Provide guidance and recommendations to providers and medical leadership

Act as the single point of contact between health partners and our internal data and analytics teams to resolve data and operational issues with our health plan partners

Maintain an up-to-date library of documents and decisions related to our health plan relationships, inclusive of executed contracts and amendments, information on new programs, and annual metrics and reporting

Qualification

Health plan relationship managementData analysisProject managementProcess improvementSoftware proficiencyCommunication skillsCollaborationOrganizational skillsAttention to detailProblem-solvingContinuous learning

Required

Bachelor's degree in business, health administration, information management, or related field

5-7 years of industry experience supporting complex projects with internal and external stakeholders including health plans, physicians and/or providers

Strong written, verbal and presentation communication skills

Knowledge of relationship management, process improvement, and physician and member engagement

Software skills required: Word, Excel (pivot and lookup), PowerPoint, Tableau, and Salesforce

Passionate about the complexities of healthcare delivery networks and alternative payment arrangements

Collaborates well with external clients and partners

Organized, able to handle multiple projects

Attends to detail without losing the bigger picture

Builds sustainable and collaborative cross-functional relationships

Able to identify potential problems in advance and propose solutions

Excited to continuously learn and grow