Senior Specialist, IPA Quality & Performance at Akido Labs · LumiJobs

Responsibilities

The Senior Specialist, IPA Quality & Performance drives quality, cost, and risk adjustment results across the Chaffey Medical Group and My Family Medical Group IPA networks. Working under the direction of IPA Opeations Manager, the role develops and executes the performance plan for each IPA, leads practice engagement in the field, serves as the named quality contact for contracted health plans, and coordinates the work of the staff who produce supplemental data and chart evidence.
Most practices in these networks are independently owned, and many contract with more than one IPA. This role has no direct authority over how those practices operate. Results come from relationships, credibility with physicians and office managers, and the ability to show each practice why performing for this IPA is worth their time and money. Measure knowledge can be taught quickly; the ability to move independent practices cannot, and it is the core qualification for this job.
Network performance strategy
Develop and execute the annual quality, cost, and risk adjustment performance plan for each IPA, for approval by IPA Operations Manager, with targets tied to health plan incentive contracts across Medicare Advantage, commercial, and Medi-Cal lines of business.
Segment practices by membership, current performance, and dollars at stake. Direct field time and staff effort to where they will move results most.
Translate contract incentive economics into practice-level terms, so each practice understands what closing its gaps is worth to it.
Forecast year-end performance against plan cut points and contract targets, and adjust strategy mid-year when forecasts fall short.
Practice engagement and influence
Build and sustain working relationships with physician owners, office managers, and front-line staff, including at practices that are also affiliated with competing IPAs.
Lead practice visits, performance reviews, and education on measure requirements, documentation, and workflow. Deliver gap lists and scorecards in a form practices will actually use.
Design and run practice incentive and recognition programs within approved budget, and track whether they change behavior.
Apply the documented escalation process. Interventions and education are recorded; two documented attempts over a quarter without movement trigger escalation through the standing monthly review with IPA leadership and the Medical Director, routed as administrative or clinical as appropriate.

Senior Specialist, IPA Quality & Performance

Responsibilities

Qualification

Required

Preferred

Benefits

Company

Akido Labs

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