Plus Care Network Program Specialist

Are you passionate about the patient experience? At HCA Healthcare, we are committed to caring for patients with purpose and integrity. We care like family! Jump-start your career as a Plus Care Network Program Specialist today with HCA Healthcare.

The Plus Care Network Program Specialist will oversee the development, contracting, execution, and ongoing performance improvement efforts of our post-acute care networks, called Plus Care Networks.

This position serves as a subject matter expert for the Value-Based Enterprises (VBEs) established to ensure our Plus Care Networks comply with Value-Based Arrangement Safe Harbors under the Anti-Kickback statutes (AKS); specifically, Safe Harbors protecting the “Care Coordination Arrangements to Improve Quality, Health Outcomes and Efficiency.”

This position serves as the primary support contact for the contractual agreements that exist between owned and independent post-acute care providers participating and one of 25 VBEs. As the point of contact, this position will be responsible for:

• Auditing each VBE compliance with its stated purpose.
• Ensuring each VBE governing structure and deliverables are met and documented.
• Ensuring each VBE is prepared for external audits or compliance reviews.

Finally, this position will liaise with various corporate departments and leaders regarding our VBEs and post-acute network strategies to ensure initiatives are delivering value to the enterprise and are aligned with related company policies, goals, and objectives.

Duties include but are not limited to:

• Manage the process of evaluating, selecting, and contracting with post-acute providers to participate in HCA Healthcare’s Plus Care Networks (PCN).
• Develop programs to enhance and grow post-acute networks, including the development of preferred provider network selection criteria and optimization of network performance.
• Support Plus Care Network operations; initiatives, collateral, audits, and compliance, through regular coordination with field based operators and leadership to ensure consistency across Divisions and hospitals.
• Coordinate and communicate the entire contract lifecycle, from pre-award to post-execution, for Plus Care Network (PCN) participants. This will include cross-functional coordination including HCA Legal, PCN operations and facility operations/leadership.
• Maintains an accurate listing of PCN contracting relationships and affiliated post-acute provider information to support accurate data analytics.
• Responsible for maintaining all PCN related collateral, including flyers, websites, and educational material.
• Serve as the department's subject matter expert on its Value-Based Enterprises, established to support the Plus Care Networks objectives. Ensures all compliance requirements and documentation are in good standing.
• Provide education to internal and external stakeholders on PCN and VBE program deliverables and compliance requirements.
• Represent the corporate Bundled Payments Department as requested with HCA Legal, Compliance, and Internal Audit to ensure programs are administered in accordance with all internal and external regulations audit requirements.
• Ensure all PCN related compliance documentation is saved and organized in accordance with document retention guidelines.
• Liaison with key stakeholders for all issues related to the development, execution, and ongoing management of PCNs and VBEs. Must possess a strong attention to detail to ensure all compliance requirements are met.
• Promote effective teamwork.
• Communicate and escalate unresolved issues at the appropriate time and to the appropriate level of management.

• Proficient in Microsoft Excel and Power Point
• Knowledge of acute and post-acute…