Manager-Practice Transformation (Full-time Remote, North Carolina Based)

The Manager of Practice Transformation provides oversight and direction to the Practice Transformation Specialists (PTS).  Oversee the PTS work with Advanced Medical Homes (AMH+) and Care Management Agencies (CMA).  Help develop the strategy for the PTS team in order for the AMH+ and CMAs to meet members needs and fulfill their CM credentialing criteria. Will work closely with the Sr Director of Payer and Practice Transformation to define the vision of the department based on data patterns and trends, Medicaid requirements and member needs.

The Manager of Practice Transformation is responsible for ensuring that the Practice Transformation team is performing effectively and efficiently in compliance of all applicable policies and contractual requirements, which include but is not limited to, auditing of work tasks, resolving provider issues, reviewing reports and developing work processes.

This position is full-time remote. Selected candidate must reside in North Carolina. Some travel for onsite meetings to the Home office may be required.

Responsibilities & Duties

Manage and Develop Staff to Ensure the Unit is Effective

• Define and deliver the direction of the team(s) to ensure alignment to organizational and personal goals


• Prioritize work and responsibilities to ensure objectives and priorities are aligned with business initiatives. Works with team members to create employee development plans to improve core competencies in alignment with organizational objectives


• Responsible for establishing and implementing a safe working environment that meets all licensure, regulatory, and accreditation requirements


• Monitor and manage staff productivity and interaction with providers, CIN and internal Alliance staff


• Ensure staff are well trained in Alliance and Practice Transformation policies, procedures, and business processes


• Ensure the department has the needed tools to fulfill functions and support employees with continuous quality improvement, interventions, Value Based Care, shift to data informed care management and total cost of care


• Provides ongoing coaching and mentoring to staff on new technology tools and practices, including change management practices, to support a learning environment to advance team skills


• Monitor PTS interactions and frequency of provider interactions and CINS and the frequency of provider and CIN interactions


• Manage PTS workloads and provide daily directions on meeting team goals


• Assess quality measures and coach Practice Transformation Specialists to provide effective on-going monitoring of provider’s drive to CQI and data informed care management

Provide Training and Coaching to Network Providers

• Effective listening and ability to identify solutions, especially for continuous quality improvement initiatives, data informed care management and the drive towards Total Cost of Care


• Ability to create and deliver presentations on various topics


• Educate on available resources and systems


• Assist Practice Transformation Specialists in resolving provider issues through 1:1 supervisions and attending provider and CIN calls

Understand Data

• Effectively review data for providers, internal PTS and assist in understanding and interpreting data to lead to solutions for workflows, panels, assignments of workloads, etc.


• Lead PTS in understanding the VBC goals of providers and track/review provider trends with analysis

Support Implementation of Provider Led Care Management and Ongoing Operations and Growth of Program

• Ensure implementation with fidelity to care model


• Transparently share challenges and barriers regarding solutions for effectively implementing the data informed care management, continuous quality improvement and interventions for both


• Work with providers and CINs to focus on data and data-informed care management


• Guide PTS, clinic staff and leadership on the implementation of best practices for data informed care management


• Address barriers to effective continuous quality improvement and the shift to data informed care management 


• Propose solutions for practices/health centers to consider in addressing barriers


• Assist providers in panel management and guiding providers through understanding of panel assignments


• Assist providers with understanding their barriers in regard to the Value Based Contracting agreements

Collaborate with Internal and External Stakeholders

• Develop strong working relationships with providers, CINS, and external stakeholders by scheduling ongoing opportunities to share feedback and collaborate  


• Participate in local, regional, and state meetings as required


• Exercise conflict resolution skills to appropriately resolve issues with providers and external stakeholders


• Develop strong working relationships within Provider Networks, Provider Network Evaluation, Community Health and Well Being, as well as internal Care Management by scheduling ongoing opportunities to share feedback, collaborate, and identify shared responsibilities for achieving program and organizational deliverables

Minimum Requirements

Education & Experience

Master’s degree from an accredited college or university in Social Work, Counseling, Healthcare Administration, Public Health, Business Administration and three (3) years of post-degree experience in any of the following areas, as a healthcare quality and process improvement, population health, care management or value-based care. Previous supervision/management experience preferred.

Experience in any of the following areas would be valuable for this employee: Public speaking, mediation, presentation development, training, group facilitation, advocacy, regulations compliance, or project management

Knowledge, Skills, & Abilities

• Understanding of Health Information Technology (HIT) and its role in improving healthcare outcomes.


• Knowledge of the fundamentals of lean or PDSA process improvement 


• Moderate analytic knowledge (including pivot tables, Pareto analysis, sources of errors in data, risk adjustment, price/volume variance analysis, application of benchmarks, coefficient of variance) 


• Understanding of specifications of quality, utilization and financial metrics, specifically HEDIS


• Knowledge of population health, social determinants of health and clinical integration


• Moderate project management skills (including ability to map dependencies, identify critical path)  


• Customer service principles 


• Knowledge of CPT, ICD, and HCPCS coding 


• Ability to prioritize workload as appropriate to ensure on‐time project completion


• Proficiency in Microsoft Office Professional products, including Visio and PowerPoint


• Excellent verbal/written communication, interpersonal, analytic, and customer service skills


• Ability to use data to drive change; including presenting data performance to providers


• Ability to work effectively on simultaneous projects with competing priorities


• Ability to function in a team‐based work environment collaboratively and collegially


• Detail oriented; Highly organized


• Ability to generate trust and build collaborative relationships internally and externally

Salary Range

$89,404 - $113,990/Annually

Exact compensation will be determined based on the candidate's education, experience, external market data and consideration of internal equity. 

An excellent fringe benefit package accompanies the salary, which includes:  

• Medical, Dental, Vision, Life, Long Term Disability


• Generous retirement savings plan


• Flexible work schedules including hybrid/remote options


• Paid time off including vacation, sick leave, holiday, management leave


• Dress flexibility