JOB TITLE: ACO Program Manager
COMPANY: MCQCN 100%
REPORTS TO: Vice President, Operations
DIRECT REPORTS: N/A
STATUS: Exempt/Full-Time
WORK COMP CLASS: 8742
OUTSIDE TRAVEL: 25%
SCHEDULE: 7-7/M-F
WORK CONDITIONS: Remote
This job description is intended to be a general statement about this job and is not to be considered a detailed assignment. It may be modified at any time, with or without advance notice, to meet the needs of the organization.
Job Summary
The ACO Program Manager plays a pivotal role in supporting My Choice Quality Care Network’s participation in the Medicare Shared Savings Program (MSSP) under the Primary Care Flex (PC Flex) ACO Model. This position ensures strategic and operational alignment across participating Federally Qualified Health Centers (FQHCs), with a focus on enhancing primary care delivery through innovative, team-based, and person-centered approaches. The Program Manager serves as a liaison between CMS, the ACO, and network participants, driving compliance, performance optimization, and the transition from fee-for-service to value-based payment models.
Essential Job Functions
- Act as the primary liaison between CMS, the ACO, participating health centers, and payers.
- Act as subject matter expert in the PC Flex Model and MSSP program requirements for reporting, finances, operations and more.
- Analyze performance data (quality, cost, utilization) to identify improvement opportunities and support achievement of shared savings.
- Collaborate with ACO leadership on ACO growth strategies and engagement.
- Lead quality improvement initiatives with internal teams, including coding, high-cost clinical drivers, AWVs and more.
- Lead provider engagement and education efforts related to MSSP and PC Flex requirements, including documentation standards, workflows, and compliance.
- Monitor beneficiary assignment and recoupment, including quarterly reassessments and PPCP payment reconciliation.
- Participate in strategic planning, committees, and workgroups focused on continuous improvement.
- Maintain thorough documentation and contribute to internal and external reporting on ACO performance and progress.
- Support the MSO in the disbursement and reporting of the Prospective Primary Care Payment (PPCP) structure, including management of monthly capitation payments based on county-level benchmarks.
- Create dashboards and reports to track and communicate performance for ACO participants and ACO leadership.
- Ensure compliance with CMS requirements.
- Manage reporting requirements and compliance with all CMS and CMMI regulations.
Qualifications
- Bachelor’s degree in healthcare administration, public health, or related field (Master’s preferred).
- 2+ years of experience in healthcare, prefer experience with MSSP ACO or value-based care programs.
- Strong understanding of CMS regulations, ACO operations, and alternative payment models.
- Experience with capitation, prospective payments, and financial reconciliation in a healthcare setting.
- Excellent communication, project management, and stakeholder engagement skills.
- Proficiency in data analysis tools and healthcare reporting systems.
Physical Requirements
- Ability to sit or stand for long periods of time.
- Ability to reach, bend and stoop.
- Physical ability to lift and carry up to 20 lbs.
HIPAA/Compliance
- Maintain privacy of all patient, employee and volunteer information and access such information only on as need to know basis for business purposes.
- Comply with all regulations regarding corporate integrity and security obligations. Report Unethical, fraudulent, or unlawful behavior or activity.
- Upon hire and annually attend HCP’s HIPAA training and sign HCP’s Confidentiality & Non-Disclosure Agreement and HIPAA Privacy Acknowledgment
- Upon hire and annually read and acknowledge understanding of HCP’s HIPAA Security Policies and Procedures
- Adhere to HCP’s HIPAA Security Policies and Procedures and report all security incidents to HCP’s Privacy & Security Officer
Job Type: Full-time
Pay: $70,000.00 - $92,000.00 per year
Benefits:
- 401(k)
- 401(k) matching
- Dental insurance
- Employee discount
- Flexible schedule
- Flexible spending account
- Health insurance
- Health savings account
- Life insurance
- Paid time off
- Parental leave
- Retirement plan
- Vision insurance
People with a criminal record are encouraged to apply
Work Location: Remote
