Mosaic Health, LLC.
Manager of Program Performance page is loaded## Manager of Program Performanceremote type:
Remote - Full Timelocations:
Florida, USAtime type:
Full timeposted on:
Posted Todayjob requisition id:
M102016**Job Description Summary**The Manager, Program Performance is responsible for the ongoing management, compliance, and performance oversight of the organization’s Medicare Shared Savings Program (MSSP) ACO and future CMS successor models, as well as select commercial value-based arrangements.
This role serves as the primary owner of MSSP program administration, including CMS system management, roster and participant file submissions, required reporting, and adherence to program rules. The position works closely with clinical leadership, finance, care management, and executive leadership to ensure the organization meets all CMS requirements while supporting program performance and sustainability.**How will you make an impact & Requirements*****Essential Duties and Responsibilities**** ***Owns and manages CMS-required systems supporting MSSP participation, including ACO-MS**** ***Oversees all required MSSP submissions, including but not limited to:***
+ ***Provider and beneficiary roster management and submissions***
+ ***Participant list maintenance***
+ ***Network and eligibility validation**** ***Ensures timely and accurate completion of CMS reporting requirements, including:***
+ ***Annual, quarterly, and ad hoc submissions***
+ ***Required attestations and documentation**** ***Serves as the internal subject matter expert on MSSP program rules, timelines, and compliance requirements**** ***Monitors CMS communications and guidance to ensure ongoing alignment with program requirements and regulatory updates**** ***Develops and maintains standard reporting for executive and physician leadership related to MSSP performance and participation**** ***Identifies data discrepancies, anomalies, and submission issues; coordinates corrections and resubmissions as needed**** ***Supports audits, CMS inquiries, and validation requests related to MSSP participation**** ***Prepares executive-ready reports, summaries, and presentations and presents materials in leadership meetings**** ***Participates in cross-functional teams evaluating future CMS models or program transitions**** ***Supports continuous improvement of data accuracy, submission processes, and system workflows******Required Knowledge and Experience:***Minimum:* Bachelors degree* Required- 5+ years of healthcare experience* Medicare Advantage and MSSP ACO experience* Attention to detail* MS Office (Excel)* Critical thinking* Desire to learn / Intellectual curiosityPreferred:* Master’s degree in healthcare management or another related field* Experience with roster and network management* Experience with CMS systems including ACO-MSMosaic Health is a national care delivery platform focused on expanding access to comprehensive primary care for consumers with coverage across Commercial, Individual Exchange, Medicare, and Medicaid health plans. The Business Units which comprise Mosaic Health are multi-payer and serve nearly one million consumers across 19 states, providing them with access to high quality primary care, integrated care teams, personalized navigation, expanded digital access, and specialized services for higher-need populations. Through Mosaic Health, health plans and employers have an even stronger care provider partner that delivers affordability and superior experiences for their members and employees, including value-based primary care capacity integrated with digital patient engagement and navigation. Each of the companies within Mosaic Health provide unique offerings that together promise to improve individuals' health and wellbeing, while helping care providers deliver higher quality care. For more information, please visit www.mosaichealth.com.Mosaic Health is an Equal Employment Opportunity employer and all qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender (including gender identity and gender expression), marital status, national origin, race, religion, sex, sexual orientation, veteran status or any other status or condition protected by applicable federal, state, or local laws.If you require an accommodation for the application or interview process, please let us know and we will work with you to meet your needs. Please contact recruiting@mosaichealth.com for assistance. #J-18808-Ljbffr
Remote - Full Timelocations:
Florida, USAtime type:
Full timeposted on:
Posted Todayjob requisition id:
M102016**Job Description Summary**The Manager, Program Performance is responsible for the ongoing management, compliance, and performance oversight of the organization’s Medicare Shared Savings Program (MSSP) ACO and future CMS successor models, as well as select commercial value-based arrangements.
This role serves as the primary owner of MSSP program administration, including CMS system management, roster and participant file submissions, required reporting, and adherence to program rules. The position works closely with clinical leadership, finance, care management, and executive leadership to ensure the organization meets all CMS requirements while supporting program performance and sustainability.**How will you make an impact & Requirements*****Essential Duties and Responsibilities**** ***Owns and manages CMS-required systems supporting MSSP participation, including ACO-MS**** ***Oversees all required MSSP submissions, including but not limited to:***
+ ***Provider and beneficiary roster management and submissions***
+ ***Participant list maintenance***
+ ***Network and eligibility validation**** ***Ensures timely and accurate completion of CMS reporting requirements, including:***
+ ***Annual, quarterly, and ad hoc submissions***
+ ***Required attestations and documentation**** ***Serves as the internal subject matter expert on MSSP program rules, timelines, and compliance requirements**** ***Monitors CMS communications and guidance to ensure ongoing alignment with program requirements and regulatory updates**** ***Develops and maintains standard reporting for executive and physician leadership related to MSSP performance and participation**** ***Identifies data discrepancies, anomalies, and submission issues; coordinates corrections and resubmissions as needed**** ***Supports audits, CMS inquiries, and validation requests related to MSSP participation**** ***Prepares executive-ready reports, summaries, and presentations and presents materials in leadership meetings**** ***Participates in cross-functional teams evaluating future CMS models or program transitions**** ***Supports continuous improvement of data accuracy, submission processes, and system workflows******Required Knowledge and Experience:***Minimum:* Bachelors degree* Required- 5+ years of healthcare experience* Medicare Advantage and MSSP ACO experience* Attention to detail* MS Office (Excel)* Critical thinking* Desire to learn / Intellectual curiosityPreferred:* Master’s degree in healthcare management or another related field* Experience with roster and network management* Experience with CMS systems including ACO-MSMosaic Health is a national care delivery platform focused on expanding access to comprehensive primary care for consumers with coverage across Commercial, Individual Exchange, Medicare, and Medicaid health plans. The Business Units which comprise Mosaic Health are multi-payer and serve nearly one million consumers across 19 states, providing them with access to high quality primary care, integrated care teams, personalized navigation, expanded digital access, and specialized services for higher-need populations. Through Mosaic Health, health plans and employers have an even stronger care provider partner that delivers affordability and superior experiences for their members and employees, including value-based primary care capacity integrated with digital patient engagement and navigation. Each of the companies within Mosaic Health provide unique offerings that together promise to improve individuals' health and wellbeing, while helping care providers deliver higher quality care. For more information, please visit www.mosaichealth.com.Mosaic Health is an Equal Employment Opportunity employer and all qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender (including gender identity and gender expression), marital status, national origin, race, religion, sex, sexual orientation, veteran status or any other status or condition protected by applicable federal, state, or local laws.If you require an accommodation for the application or interview process, please let us know and we will work with you to meet your needs. Please contact recruiting@mosaichealth.com for assistance. #J-18808-Ljbffr