Value Based Care Out Patient Manager

Midland Health • Midland, TX

1d

About The Position

The Manager of Ambulatory Value-Based Care (VBC) drives performance across all outpatient value-based contracts, including Medicare Advantage, ACO, and commercial arrangements. This role oversees care gap closure, quality improvement, risk adjustment, and cost-of-care initiatives across Midland Health’s employed physician practices as well as MQA who ask for VBC training. The manager collaborates with physicians, clinic directors, analytics, finance, and compliance teams to ensure strong results in quality, patient experience, and financial performance.

Requirements

• Bachelor’s degree in Nursing, Healthcare Administration, Public Health, or related field (Master’s preferred)
• 3+ years of experience in outpatient care management, population health, or value-based care programs
• Strong knowledge of CMS programs, ACOs, HEDIS, HCC risk adjustment, MIPS, and care coordination models
• Proven leadership and team management skills
• Excellent communication, analytical, and project management abilities

Nice To Haves

• RN, LVN or clinical license
• Experience with Athena, or other EHR platforms
• Familiarity with payer portals and analytics tools
• Certification in Case Management (CCM) or Value-Based Care

Responsibilities

• Design, implement, and oversee outpatient care models aligned with value-based care principles.
• Collaborate with Physicians, APP Providers, clinical and administrative teams to ensure seamless care coordination and transitions.
• Collaborate with VBC Plans and ACO Representatives on ongoing goals and objectives, reviewing monthly dashboard, scorecards, clinical algorithm and other initiatives.
• Supervise quality specialist, care coordinators, case managers, and other outpatient staff involved in value-based programs.
• Provide coaching, training, and performance evaluations to ensure team success across all VBC MQA providers.
• Serve as liaison between outpatient teams, payers, and leadership to align goals and communicate outcomes.
• Facilitate multidisciplinary meetings and case reviews to support high-risk patient management.
• Ensure adherence to regulatory requirements and payer contract terms.
• Prepare and present reports on program performance, utilization trends, and financial impact.

What This Job Offers

• Job Type: Full-time
• Career Level: Manager
• Number of Employees: 11-50 employees