LTC ACO, a subsidiary of Genesis HealthCare, began in 2016 as the first Accountable Care Organization (ACO) focused on the special needs of Medicare Beneficiaries residing in long-term care (LTC) facilities. This includes, but is not limited to, the frail elderly, individuals living with Alzheimer's disease or dementia, depression, amputations, developmental or physical disabilities, renal failure and individuals with multiple chronic diseases with complications. By participating in LTC ACO, physicians and LTC nursing centers will finally be recognized and rewarded for improving the quality and cost of care delivered to this vulnerable subset of the Medicare population.
The LTC ACO's mission is to dramatically improve the quality and cost of healthcare delivered to these Medicare Beneficiaries, rewarding participating providers for achieving these outcomes. It is our vision to revolutionize the way healthcare is provided to Medicare Beneficiaries residing in LTC nursing centers. Visit our website: https://www.ltcaco.com/index.html
Join the LTC ACO as the Clinical Performance Enhancement where you will work closely with ACO Operations and Clinical Quality Teams to ensure maximum effectiveness of all LTC ACO providers in meeting the regional clinical and operational goals and objectives.
*Establish and maintain relationships with providers to include LTC ACO Contracted Providers and skilled nursing facilities that participate with the ACO. Assists with onboarding new LTC ACO participants.
*Coordinate with contracted Physicians, Medical Practices and Long Term Care Facilities to implement utilization, quality, and coding improvement efforts.
*Communicate LTC ACO policies and progress towards ACO attribution goals, and reviews quality, utilization and financial outcomes with Providers and LTC Facilities.
*Understand, develop, track, monitor and report on key program clinical and quality performance metrics within assigned groups/geographies.
*Partner with provider groups and facilities to implement, and ensure follow-through on clinical performance improvement plans.
*Contribute to the development and execution of programs and processes that will continue to define the LTC ACO Clinical Model, in conjunction with the VP of Quality and VP of Medical Affairs.
*Conduct periodic audits of new provider clinical quality measure medical record documentation.
*Registered Nurse license. *At least 5 years of experience in Managed Care, Skilled Nursing, or Practice Management is required. Quality Measure Understanding and Chart Audit Experience, including quality, documentation and coding are required. *Must have knowledge of physician practice and facility operations, and experience managing complex physician and skilled nursing facility relationships. *Excellent presentation and interpersonal skills, poise and professionalism are required. *Proficiency in Microsoft Office Suite is desired, experience with Gmail is preferred. *Must be available via phone and/or email to address physician emergencies. *Must be able travel to LTC ACO providers and/or skilled nursing facilities. *Bachelors/Master's degree in Business, Finance, Operations, Health Administration or related field a plus, but not required.
Position Type: Full Time
Req ID: 377085
Center Name: Genesis HealthCare
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