Risk Adjustment Operations Manager

at  Somatus Inc

Overview:
As the largest and leading value-based kidney care company, Somatus is empowering patients across the country living with chronic kidney disease to experience more days out of the hospital and healthier at home.
It takes a village of passionate and tenacious innovators to revolutionize an industry and support individuals living with a chronic disease to fulfill our purpose of creating More Lives, Better Lived. Does this sound like you?
Showing Up Somatus Strong

We foster an inclusive work environment that promotes collaboration and innovation at every level. Our values bring our mission to life and serve as the DNA for every decision we make:

• Authenticity: We believe in real dialogue. In any interaction, with patients, partners, vendors, or our teammates, we are true to who we are, say what we mean, and mean what we say.
• Collaboration: We appreciate what every person at Somatus brings to the table and believe that together we can do and achieve more.
• Empowerment: We make sure every voice gets heard and all ideas are considered, especially when it comes to our patients’ lives or our partners’ best interests.
• Innovation: We relentlessly look for ways to improve upon the status quo to continuously deliver new solutions.
• Tenacity: We see challenges as opportunities for growth and improvement — especially when new solutions will make a difference for our patients and partners.

Showing Up for You

We offer more than 25 Health, Growth, and Wealth Work Perks to help teammates learn, grow, and be the best version of themselves, including:

• Subsidized, personal healthcare coverage (medical, dental vision)
• Accrual of 3 weeks’ Vacation (PTO)
• Professional Development, CEU, and Tuition Reimbursement
• Curated Wellness Benefits supporting teammates physical and mental well-being
• Community engagement opportunities
• And more!

We are actively recruiting for a Risk Adjustment Operations Manager to join our team. This role will be focused on successfully driving the launch, adoption and subsequent refinement of several technology products and workflows in our proprietary suite of software tools, RenalIQ. Strong communication is required to curate and disseminate specialty-related deliverables, including workflows, user guides, marketing collateral as well as to assist with roadmaps and requirement documents. Excellent interpersonal skills are required to work closely with market clinical operations teams, the central population health team, and the technology team.
This role is a fully remote position, applicable state licensure may be required.

Responsibilities:

• Acts as an advisor to the SVP of Operations and SVP of Clinical Innovation to create, execute, and measure Nurse Practitioner responsibilities
• Serve as the Subject Matter Expert providing input to identify ways for efficient and effective utilization of NP staff and resources
• Provide guidance and training to new and existing NP teams
• Provides guidance to NP staff ensuring that interventions meet or exceed contractual performance goals, ensures delivery of interventions are in accordance to Somatus clinical model expectations
• Identifies staff training needs and ensures development and implementation of programs that address needs, participates in delivering training session to meet the needs of staff related to clinical/program needs
• Present ideas, information, and viewpoints clearly, both verbally and in writing
• Demonstrated ability to adapt to changing needs by acquiring new skills and knowledge
• Know and comply with all state and federal regulations relating to the Nurse Practitioner scope of practice
• Demonstrated knowledge in Kidney care and ability to understand the Nurse Practitioner’s role in managing Kidney disease patients
• Participate in community collaborative efforts
• Develop program material and outreach materials, update regularly to ensure accuracy of information and evaluate the effectiveness on an ongoing basis
• Maintains current knowledge of policies and regulations in the Nurse Practitioner field, especially related to kidney care
• Serve as an internal referral escalation lead for field Nurse Practitioners to navigate difficult cases and to conduct community outreach where indicated
• Understand user workflows with an eye for automation and user experience improvement
• Translate workflow observations into business and technical requirement documents for a development team
• Develops release notes, product presentations, trainings, communications, and user guides
• Helps to select, train, and measure effectiveness of preceptors within the specialty
• Assist with interviewing and making recommendations to hire Nurse Practitioners for field teams

Please note this job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee for this job. Duties, responsibilities, and activities may change at any time with or without notice.
Qualifications:

Required

• Bachelor’s Degree in health-related field
• 3-5 years of program management experience or operational experience in population health, managed care, case management, or healthcare consulting
• 3-5 years of Medical Risk Adjustment experience
• Demonstrated advanced knowledge of case management and care coordination of services specific to the Somatus clinical model
• Have experience in working with an outcome-based program using data to drive performance improvement strategies for both program services and personnel
• High organized and detail oriented with the ability to execute on multiple priorities

Preferred

• Licensed Nurse Practitioner
• Renal/Dialysis experience
• Experience working with patient and provider engagement platforms
• Experience with data analysis, preferably with usage logs from digital health applications
• Acute attention to detail to create and drive project plans
• Orientation towards customer delight
• Ability to innovate and navigate ambiguity
• Self-starter who will take initiative and be proactive when there are multiple priorities
• Strategy solution-seeker who sees opportunities when others see barriers
• Strong interpersonal skills and ability to communicate effectively
• Experience implementing digital health products

Other Duties : Please note this job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee for this job. Duties, responsibilities, and activities may change at any time with or without notice. Our priority is the health and safety of our members, colleagues, partners, and community. Proof of COVID-19 Vaccination is required for employment. If you are unable to be vaccinated for medical reasons or sincerely-held religious beliefs, we will consider requests for reasonable accommodations consistent with our policy, and where we are able to provide such accommodations without undue hardship to the company pursuant to applicable law. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. Somatus, Inc. provides equal employment opportunity to all individuals regardless of their race, color, creed, religion, gender, age, sexual orientation, national origin, disability, veteran status, or any other characteristic protected by state, federal, or local law. Further, the company takes affirmative action to ensure that applicants are employed, and employees are treated during employment without regard to any of these characteristics. Discrimination of any type will not be tolerated

• Acts as an advisor to the SVP of Operations and SVP of Clinical Innovation to create, execute, and measure Nurse Practitioner responsibilities
• Serve as the Subject Matter Expert providing input to identify ways for efficient and effective utilization of NP staff and resources
• Provide guidance and training to new and existing NP teams
• Provides guidance to NP staff ensuring that interventions meet or exceed contractual performance goals, ensures delivery of interventions are in accordance to Somatus clinical model expectations
• Identifies staff training needs and ensures development and implementation of programs that address needs, participates in delivering training session to meet the needs of staff related to clinical/program needs
• Present ideas, information, and viewpoints clearly, both verbally and in writing
• Demonstrated ability to adapt to changing needs by acquiring new skills and knowledge
• Know and comply with all state and federal regulations relating to the Nurse Practitioner scope of practice
• Demonstrated knowledge in Kidney care and ability to understand the Nurse Practitioner’s role in managing Kidney disease patients
• Participate in community collaborative efforts
• Develop program material and outreach materials, update regularly to ensure accuracy of information and evaluate the effectiveness on an ongoing basis
• Maintains current knowledge of policies and regulations in the Nurse Practitioner field, especially related to kidney care
• Serve as an internal referral escalation lead for field Nurse Practitioners to navigate difficult cases and to conduct community outreach where indicated
• Understand user workflows with an eye for automation and user experience improvement
• Translate workflow observations into business and technical requirement documents for a development team
• Develops release notes, product presentations, trainings, communications, and user guides
• Helps to select, train, and measure effectiveness of preceptors within the specialty
• Assist with interviewing and making recommendations to hire Nurse Practitioners for field team