Payment Programs Coordinator

Bayhealth Dover , DE 19903

Posted 3 weeks ago

Job Details

The Coordinator, Payment Programs will plan, direct and monitor quality of population-based programs throughout ambulatory clinical practices.

The Coordinator will oversee the implementation and maintenance of ambulatory practice standards which support the delivery of patient-centered, cost effective and quality driven care. The individual will work with the Director, Clinical Integration and other Bayhealth leadership to measure physician performance and care outcomes through the compilation and analysis of data and communication of results. The incumbent will be responsible for all quality and data reporting to third party payors.

The Coordinator will work closely with Bayhealth affiliated practices and physician groups to build population health programs, chronic disease programs, e.g., diabetes, obesity, hypertension, work to support physician relationships, and improve internal communication related to Bayhealth value-based care initiatives.

Minimum Education and Experience





APRN, MSN, or related Masters

5 years ambulatory experience, including at least 3 years in a supervisory position, preferably in a large medical group
3 years of experience in utilization/medical management, quality improvement, health care analytics, or experience in a physician medical group that has successfully implemented quality improvement initiatives.
7 years or more of ambulatory experience, including at least 3 years in a supervisory position, preferably in a large medical group

Computer/Software Knowledge:

Proficiency with Excel, Word, PowerPoint, EMR

Epic, Advanced proficiency with Microsoft Excel, Word, Access, and PowerPoint


Active DE RN license

CPHQ certification

NCQA PCMH CCE (certified content expert)

Special Knowledge, Skills, and/or Abilities

  • Must be able to work collaboratively in a highly-matrixed organization and be able to build consensus across multiple constituencies.

  • Strong organizational and project management skills

  • Excellent judgment and creative problem solving skills

  • Proven experience with risk-sharing models of care, e.g., BPCI (Advanced), ACO, or PCMH

  • Hands on familiarity with ambulatory EMR systems (i.e., EPIC)

  • Proven track record of accountability and results

  • Experience with survey processes preferred, e.g., Joint Commission, DOH and ambulatory accreditation

  • Comprehensive knowledge of medical practice operations in a health system environment.

  • Strong negotiation skills; including the ability to gain acceptance from others of a plan or idea to achieve a mutually beneficial outcome

  • Excellent verbal and written communication skills; ability to speak clearly and concisely, conveying complex or technical information in a manner that others can understand, as well as the ability to understand and interpret complex information from others. Must be proficient in reading, writing, and speaking English.

  • Demonstrated ability to present in large groups

  • Demonstrated effectiveness in performing statistical analysis and presentation of physician utilization data, including one-on-one meetings with physicians preferred

  • Demonstrated ability to work independently as well as in a virtual team environment.

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Payment Programs Coordinator