ConcertoCare

Director

• Reporting to ConcertoCare’s Vice President of Population Health
• Develop and manage strategies to address utilization and high-cost medical expenses for the assigned market(s) population
• Ensure key components of ConcertoCare’s Care Model are being used by providers to drive population impact
• Support the mission, vision, and values of ConcertoCare in delivering individualized, proactive care to high-risk patients
• Work in conjunction with the Population Outcomes Manager and collaborate with the Market Medical Director(s) and other Directors of Population Outcomes
• Identify and analyze impactable utilization trends
• Partner with interdisciplinary teams to identify and plan interventions
• Prepare case summaries for interdisciplinary discussion
• Perform Population Surveillance on assigned market(s) population
• Utilize internal and external reporting tools to guide opportunities to reduce avoidable utilization
• Design, implement, and manage projects in partnership with key leaders
• Collaborate with actuarial and med economics team to identify trends in cost and utilization data
• Compile data for use in Joint Operating Committee Meetings
• Support customer success through leading meetings with payer case management teams and community resources/vendors
• Manage and aggregate patient and MLR data, create presentations for internal and external partners
• Lead market-level medical expense management activities and presentations

Director of Population Outcomes

Data Analyst

• Leads workflow and tool development, process improvement, implementation, and performance monitoring for key Population Health initiatives
• Serves as the organization-wide program manager for designated initiatives
• Works closely with market-level population health teams and leaders to support achievement of nursing and case management outcomes
• Develops and maintains enterprise-wide processes and programs in collaboration with Directors and Vice Presidents of Population Health
• Serves as a business owner in partnership with IT and Analytics teams
• Ensures tools and reporting solutions are designed to meet operational and clinical business needs
• Key responsibilities include leading user acceptance testing and data validation activities, monitoring workflow functionality
• Collaborates with cross-functional program leaders to strengthen implementation processes and reporting over time
• Provides indirect leadership through the development and delivery of training and train-the-trainer programs

Population Health Program – Analytics Manager

Human Resources

• Work closely with the Chief People Officer and partner with the HR team to drive analytical solutions to engage employees.
• Perform analytical and project management tasks associated with recruiting & workforce metrics, leave management, employee engagement, performance appraisals, and other personnel programs within the Human Resources Department.
• Track and consolidate HR metrics associated with recruiting and turnover in partnership with the Talent Acquisition team.
• Collect, compile, organize, and provide professional analysis data relating to talent acquisition and diversity trends.
• Create and maintain HR dashboards using relevant HR metrics to identify trends.
• Manage all Leave of Absence (LOA) requests from ConcertoCare employees.
• Administer the annual employee engagement survey process and market specific pulse surveys.

HR Analyst

Actuary

• The Senior Actuarial Analyst will play a key role in shaping ConcertoCare’s continued growth by building actuarial models and studies that guide decision-making across pricing, forecasting, and value-based care contract performance.
• Design and perform actuarial studies and reports related to medical costs, risk scores, revenue, and membership.
• Analyze results to identify early signs of adverse trends or other issues related to medical care costs and premium-based revenue.
• Inform the financial forecast with actuarially-sound studies to enhance accuracy.
• Support Finance in business development discussions, contributing strong recommendations on how to best structure risk-sharing arrangements through a combination of historic and predictive analytics.
• Work with IT partners to create reporting in analytic tools such as Power BI.
• Conduct studies on the value of existing and potential interventions and clinical programs.

Senior Actuarial Analyst

Manager

• Conduct initial intake calls as well as scheduled and urgent patient outreach based on individual patient’s needs and risk levels to review and update the care plan, monitor progress, ensure needs are met, and identify new areas of concern.
• Provide ongoing care coordination for an assigned panel of complex patients.
• Conduct needs assessments and develop plans of care in partnership with the rest of the patient’s care team.
• Ensure care is coordinated, patient-centered, and aligned with the needs and wishes of the patient.
• Support patients during care transitions, including outreach and assessment during and post hospitalization to ensure discharge needs are addressed, to facilitate provider follow-up, and to perform medication reconciliation.
• Identify and implement interventions and collaborate closely with ConcertoCare’s multidisciplinary team (providers, Director of Clinical Care, social work, behavioral health, and clinical pharmacy), external providers, and social service organizations to: (1) address gaps in care, (2) mitigate the risk of inpatient admissions, readmissions, emergency room visits and movement to an institutional setting, (3) and keep patients safely living in their desired and appropriate home environment.
• Identify and verify appropriate utilization of resources across the continuum of care.
• Actively participate in interdisciplinary care team huddles, and other clinical meetings.
• Participate in quality improvement and evaluation processes.
• Adhere to compliance policies, procedures, and standards of conduct including all applicable laws and regulations.
• Serve as a mentor for new hires and existing case management team members.
• Other duties as assigned.

Director of Population Outcomes

Population Health Program – Analytics Manager

HR Analyst

Senior Actuarial Analyst

RN Case Manager