The core responsibility of this highly visible position is the overall management the organization's performance under the Medicare Access & CHIP Reauthorization Act (MACRA). This includes the organization's participation in the Merit-Based Incentive Payment System (MIPS) track with a goal of successfully transitioning to the risk-based Alternative Payment Model (APM) track. The incumbent is responsible for overall compliance with federal requirements, responding to any Centers for Medicare and Medicaid Services (CMS) audits, leading the Regional MACRA Steering team, organizational strategy and education, and regular communication with leadership.
1. Serve as the Wisconsin region's MACRA subject matter expert (SME); provide ongoing education, serve as primary point of contact for System, etc.
2. Maintain accurate and complete database of CMS-defined eligible clinicians
3. Develop and present formal presentations on progress, justifications, and details to oversight committees, sponsors, and leadership.
4. Working with sponsors and leadership, create and manage the MACRA Project Plan for DMG including scope, schedule, budget, communication, risk management, etc.
5. Work with management to acquire resources for projects (team members) and ensure tasks are assigned to appropriately skilled resources.
6. Identify and resolve dependencies and constraints by working with sponsors and leadership.
7. Respond to all CMS audits in a timely, accurate, and comprehensive manner
8. Facilitate the implementation of workflow changes in order to maximize the organization's financial performance under MACRA
9. Monitor changes to MACRA legislation; respond to and implement any necessary organizational changes
10. Ongoing monitoring of all clinical and financial metrics related to MACRA
11. May be asked to participate in strategy formation relative to other value-based payment arrangements that impact DMG reimbursement
12. Other duties as assigned.
1. Bachelor's degree with at least 5 years of experience in a healthcare organization
2. Demonstrated experience with quality improvement tools and methodologies
3. Previous project/program management experience
4. Demonstrated ability to function at a high level in a dynamic work environment.
5. The ability to meet deadlines and work under pressure while providing a positive image
6. Strong leadership skills
7. Excellent organizational skills and the ability to work within all levels of the organization
8. Excellent written and oral communication skills.
9. Strong analytical, problem solving, facilitation, and interpersonal skills.
10. Experience with change management and act as subject matter expert (SME) for courses of action and influence key stakeholders
1. Previous experience with CMS provider incentive programs such as Meaningful Use, Physician Quality Reporting System (PQRS), MIPS, APM, bundled payments, etc.
2. Previous experience with the Epic (electronic health record software)
3. Previous experience with risk-based alternative payment models such as an accountable care organization (ACO), Shared Savings Program, Comprehensive Primary Care Plus (CPC ), bundled payments, etc.
4. Experience with implementing change within an healthcare organization
Essential Physical Functions:
The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
1. This is a predominately office setting environment.
2. Ability to sit for extended periods while on the phone or computer.
3. Ability to continuously see fine print and to use the computer for extended periods.
4. Ability to perform fine motor tasks, such as computer, writing or phone tasks.
5. Ability to hear and converse on the phone and in person.
6. Ability to safely drive a personal vehicle at least weekly and comply with the Company's Fleet/Driver Safety Program.
About SSM Health Dean Clinic-
Based in Madison, Wis., Dean Clinic consists of a network of more than 60 clinics in south-central Wisconsin. Our more than 500 physicians provide primary, specialty and tertiary care in the clinics as well as eye care through our Davis Duehr Dean locations. Dean Clinic also offers urgent care services and operates outpatient surgery centers. Dean Clinic joined SSM Health in 2013.
You’ve known us as many names throughout St. Louis, and now, we’re bringing our hospitals, doctors, home care and other services together under one name – SSM Health. With seven hospitals, 350+ physicians, more than 40 physician locations and 12,000 employees, we are part of something bigger and better. We’re connected to a wealth of resources, expertise and advance technology to help you, your fa...mily and our community live long, healthy lives.
We’ve grown and changed a lot over our 143-year history. Our name may be changing but our mission remains the same