Prominence Health is a value-based care organization bridging the gap between affiliated health systems and independent providers, building trust and collaboration between the two. Prominence Health creates value for populations and providers to strengthen integrated partnership, advance market opportunities, and improve outcomes for our patients and members. Founded in 1993, Prominence Health started as a health maintenance organization (HMO) and was acquired by a subsidiary of Universal Health Services, Inc. (UHS) in 2014. Prominence Health serves members, physicians, and health systems across Medicare, Medicare Advantage, Accountable Care Organizations, and commercial payer partnerships. Prominence Health is committed to transforming healthcare delivery by improving health outcomes while controlling costs and enhancing the patient experience.

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Job Summary: The Senior Director, Performance Improvement provides strategic leadership in the planning, development, implementation and execution of all aspects of a robust portfolio of value-based programs and strategies within the Prominence Health umbrella. Emphasis will be centered around risk-based contract performance, risk adjustment, and quality measurement performance across various Prominence Health business entities and partnerships. The most immediate focus for this position will be Riverside Medical Clinic and the advancement of its value based MSO strategy. The objective of this position is to optimize clinical quality and revenue opportunities for Prominence Health entities as well as to develop out a centralized support layer across businesses to enable reliable, scalable, high-performance operations in support of value based performance.

Key responsibilities include optimizing revenue opportunities by ensuring members receive appropriate medical care that is accurately coded so that the members' risk scores are optimized and compliant with regulatory reporting standards. The Senior Director has programmatic oversight and responsibility for achieving all risk adjustment, quality, and overall value based contract performance outcomes. The Senior Director works closely with partner stakeholders and business leaders to ensure the development and implementation of population health and quality improvement initiatives aligned with Prominence Health's clinical, business, quality measurement, and improvement strategies. The Senior Director will advise on best practices, leverage centralized Prominence Health resources, and enable the businesses supported to develop the competencies and programs that will achieve top tier performance.

Must work collaboratively with other Prominence Health and UHS partner organizations, including Actuarial, IS, Legal, Health Services, Network Management, Quality Improvement and others to manage the risk adjustment and quality measurement process. Must develop or recommend the purchase tools that will result in leveraging information to manage member analytics in order to more effectively direct resources and activities to meet risk adjustment and quality measurement objectives. In carrying out these responsibilities, The Senior Director works closely with external vendors and consultants, runs outsourced health risk assessment programs, develops training programs & tools to address the educational needs of providers and non-clinical staff, assists in the development of analytic and reporting tools, and assists in the development of data collection systems and workflows to fulfill CMS and quality measurement requirements.

Benefit Highlights:

• Loan Forgiveness Program
• Challenging and rewarding work environment
• Competitive Compensation & Generous Paid Time Off
• Excellent Medical, Dental, Vision and Prescription Drug Plans
• 401(K) with company match and discounted stock plan
• SoFi Student Loan Refinancing Program
• Career development opportunities within UHS and its 300+ Subsidiaries! * More information is available on our Benefits Guest Website: benefits.uhsguest.com

About Universal Health Services:

One of the nation's largest and most respected providers of hospital and healthcare services, Universal Health Services, Inc. (UHS) has built an impressive record of achievement and performance. During the year, UHS was again recognized as one of the World's Most Admired Companies by Fortune; and listed in Forbes ranking of America's Largest Public Companies. Operating acute care hospitals, behavioral health facilities, outpatient facilities and ambulatory care access points, an insurance offering, a physician network and various related services located all over the U.S. States, Washington, D.C., Puerto Rico and the United Kingdom.

Qualifications and Regulatory Requirements:

• Master's Degree in Business Administration, Finance, Health Care Administration, Management or related field preferred.
• At least 5 years of health care experience working with value based Medicare Advantage STARS/HEDIS programs.
• At least 3 years of health care experience working with Medicare and/or Commercial risk adjustment programs. Requires working knowledge of CMS risk adjustment methodologies and quality improvement measures.
• Ability to effectively communicate in English, both verbally and in writing.
• Knowledge of regulatory quality-based reporting and audit requirements;
• Proficiency in interpreting results and formulating recommendations/action plans;
• Ability to research and analyze state/federal regulations related to health insurance and healthcare;
• Demonstrated skills in critical thinking, problem-solving, and the analysis, interpretation and evaluation of complex information;
• Excellent computer skills. Microsoft Office Suite
• Personable and demonstrated ability to develop and maintain relationships at all levels.
• Well organized and demonstrate strong attention to the detail
• Ability to understand, present and analyze data.
• Strong verbal and written communication skills.
• Versatile and flexible. Inquisitive mind with strong analytical skills and the ability to do complex problem solving.
• Strong project management, meeting process and presentation skills.

EEO Statement

All UHS subsidiaries are committed to providing an environment of mutual respect where equal employment opportunities are available to all applicants and teammates. UHS subsidiaries are equal opportunity employers and as such, openly support and fully commit to recruitment, selection, placement, promotion and compensation of individuals without regard to race, color, religion, age, sex (including pregnancy, gender identity, and sexual orientation), genetic information, national origin, disability status, protected veteran status or any other characteristic protected by federal, state or local laws.

We believe that diversity and inclusion among our teammates is critical to our success.

Avoid and Report Recruitment Scams

At UHS and all our subsidiaries, our Human Resources departments and recruiters are here to help prospective candidates by matching skill set and experience with the best possible career path at UHS

and our subsidiaries. During the recruitment process, no recruiter or employee will request financial or personal information (e.g., Social Security Number, credit card or bank information, etc.) from you via email. Our recruiters will not email you from a public webmail client like Hotmail, Gmail, Yahoo Mail, etc.

If you suspect a fraudulent job posting or job-related email mentioning UHS or its subsidiaries, we encourage you to report such concerns to appropriate law enforcement. We encourage you to refer to legitimate UHS and UHS subsidiary career websites to verify job opportunities and not rely on unsolicited calls from recruiters.

If you would like to learn more about the opportunity, please contact Bridget Gomez at: