Alternative Payment Model Coordinator (Hybrid/Troy, MI) - Health Alliance Plan

Alternative Payment Model Coordinator (Hybrid/Troy, MI) - Health Alliance Plan Health Alliance Plan - 3.7 Troy, MI Job Details 1 day ago Qualifications Microsoft Excel Presentation software Microsoft Teams SharePoint Full Job Description

GENERAL SUMMARY

The Alternative Payment Model (APM) Coordinator supports the planning, implementation, and ongoing management of value-based care programs and alternative payment models across the organization. This role ensures accurate tracking of quality metrics, financial performance, reporting requirements, provider engagement, and compliance with payer and government program expectations. The APM Coordinator works closely with clinical, operational, financial, and analytics teams to improve outcomes and support organizational success in value‑based arrangements.

PRINCIPLE DUTIES AND RESPONSIBILITIES

Coordinate activities related to CMS, commercial, and Medicaid/Medicare Advantage APMs (e.g., Shared Savings, Bundled Payments, PCMH, ACO programs). Maintain program timelines, deliverables, reporting requirements, and communication workflows. Support readiness assessments and implementation plan for new APM contracts or performance years. Tracks impactful program elements such as payment timelines & notification requirements. Monitor quality, cost, utilization, and risk-adjustment metrics tied to APM performance. Collaborate with analytics teams to validate data accuracy and identify trends or performance gaps. Assist in preparing dashboards and reports for clinical leadership and executive teams. Provider & Stakeholder Engagement. Serve as a liaison between clinical teams, administrative staff, payers, and leadership regarding APM activities. Coordinate provider education on program requirements, quality measures, risk coding, and performance updates. Support communication plans that drive provider alignment and engagement in APM initiatives. Ensure compliance with payer program guidelines, CMS reporting expectations, and contract requirements. Maintain accurate program documentation, audit files, and policy materials. Assist with preparation of materials for internal and external audits. Operational Support. Facilitate regular APM meetings, prepare agendas, track action items, and drive accountability. Support cross‑functional teams with workflow development, documentation updates, SOPs, and improvement initiatives. Monitor deadlines, submissions, and payer notifications to ensure timely completion. Perform additional responsibilities as assigned.

EDUCATION/EXPERIENCE REQUIRED

Bachelor's degree in healthcare administration, Business, Public Health, or related field (or equivalent experience). Minimum of two (2) years of experience in healthcare administration, population health, value‑based care, managed care, or quality improvement. Understanding of APM concepts such as shared savings, bundled payments, risk adjustment, HEDIS measures, and value-based contracts. Strong analytical, organizational, and project coordination skills. Proficiency with Microsoft tools (Excel, Teams, SharePoint, PowerPoint) and data systems. Excellent verbal, written, and interpersonal communication abilities. Experience with CMS Innovation Center models, ACOs, or pay-for-performance programs, preferred. Familiarity with healthcare quality frameworks (NCQA, HEDIS, CMS Star Ratings, MIPS), preferred. Experience working with EMRs, population health platforms, or analytics tools, preferred. Project management or lean process improvement experience/certification (e.g., CAPM, Lean Six Sigma), preferred.