The Value-Based Care Specialist supports the development, implementation, and monitoring of value-based care initiatives that improve quality outcomes, enhance patient experience, and optimize reimbursement under payer performance contracts.
Working closely with clinical, operational, and data teams, this role helps ensure the health center meets or exceeds key performance metrics, including UDS, HEDIS, PCMH, and other payer quality measures. The specialist supports population health strategies that advance the organization’s transition to a value-based reimbursement model within a Federally Qualified Health Center (FQHC) setting.
Key responsibilities include:
- Reviewing patient charts and payer portals to identify care gaps
- Contacting patients to support follow-up and close care gaps
- Maintaining accurate medical records, attribution lists, spreadsheets, and documentation
- Coordinating with internal teams and external partners on population health and value-based care initiatives
- Monitoring quality and cost metrics, dashboards, reports, and payer performance
- Supporting audits, payer reviews, and compliance activities
- Providing training and support on value-based care workflows, documentation, and coding best practices
- Assisting with communication between clinical teams, payors, and leadership on quality and cost-of-care initiatives
Education and experience
- Bachelor’s degree in Healthcare Administration, Public Health, Nursing, or a related field required; master’s degree preferred
- Minimum of 3 years of experience in healthcare quality, population health, data analytics, or value-based care coordination
- Experience in an FQHC, community health, or managed care environment strongly preferred
- Working knowledge of value-based payment models such as pay-for-performance, shared savings, and capitation
Knowledge and skills
- Strong understanding of healthcare quality measures, including UDS, HEDIS, and NCQA-PCMH
- Proficiency with EHR systems, data extraction tools, and Microsoft Excel
- Strong analytical, critical-thinking, and problem-solving skills
- Excellent verbal and written communication skills
- Ability to manage multiple projects and deadlines in a fast-paced environment
- Commitment to health equity and community health
- Bilingual English/Spanish highly preferred
- Valid driver’s license and auto insurance required for travel between clinic locations
Additional qualifications
- Current BLS certification for healthcare providers is highly recommended
- Medical Assistant certification is highly recommended
- Prior experience as a Medical Assistant is a plus
Excellent benefits package including:
- Medical insurance
- Dental insurance
- Vision insurance
- Disability insurance
- Life insurance
- Company-matching retirement plan
- Generous paid time off
- Vacation and sick leave accrual starting on the date of hire
Location
Fort Worth, Texas, US
Employment Type
Full-time
Experience Level
Intermediate Level
Remote work allowed
No
Posted
1 month ago