Provider Performance Advisor (South Texas Market) in San Antonio, Texas at Equality Health
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Job Description
Position Title: Provider Performance Advisors
Reports To: Director, Practice Performance
Classification: Exempt
Places of Work: Field (specifically San Antonio or south TX)
About the Organization:
Equality Health is an integrated, holistic, and tech-enabled healthcare delivery system focused on improving the health and wellness of diverse populations. Founded in 2015, Equality Health aims to improve access to value-based care for people who have long struggled with navigating the traditional one-size-fits-all U.S. healthcare system. The mission of the company is to provide high-quality care that improves and enhances lives regardless of race, ethnicity, age, or income.
Through its supplemental care management services and proprietary technology platform, CareEmpower™, Equality Health helps managed care plans and health systems improve outcomes and lower costs for diverse populations while simultaneously facilitating the transition to risk-based accountability. Equality Health supports over 800,000 members and more than 4,000 practice sites and continues to scale rapidly.
In 2021, Equality Health partnered with General Atlantic, a leading global growth equity firm, to help drive continued expansion and fuel the next phase of growth as a leading value-based primary care network serving the Medicaid, Medicare and ACA Exchange populations. This strategic investment will enable Equality Health to pursue further geographic expansion, technological innovation and product development while furthering its mission of increasing access to care, lowering costs and improving outcomes for underserved individuals, families and communities.
About the Role:
The Provider Performance Advisor (PPA) is primarily a market-based position that also supports emerging markets outside of their physical location. The main role of the PPM is to enable and enhance practice performance to a proactive, accountable care, by analyzing population data to effectively measure, monitor, and manage care of patients and present results and outcomes to executive leadership. PPAs are responsible for the day-to-day support and training of all practices in the markets they cover, with feedback loops to the Practice Account Manager (PAM).
Suggested replacement for summary of the role:
The Provider Performance Advisor (PPA) is primarily a market-based position that also supports emerging markets outside of their physical location. The PPA serves as a trusted advisor, consultant, and partner to provider practices, working directly with physicians, practice leadership, and clinical teams to improve operational performance, quality outcomes, and Equality Health Value-Based Care (EH VBC) success. As the face of Equality Health within assigned markets, the PPA builds strong relationships, influences provider and staff behavior, and represents the organization with professionalism, credibility, and a consultative approach.
Through analysis of population health data, performance metrics, and practice workflows, the PPA identifies opportunities for improvement, drives practice transformation, and enables sustainable behavior change that enhances quality performance and accountability. This role partners closely with provider practices to implement performance improvement strategies, monitor progress, and deliver measurable outcomes while maintaining collaborative feedback loops with the Practice Account Manager (PAM).
Key Responsibilities:
- Enable and enhance practice performance in the EH VBC Network
- Responsible for supporting assigned practice teams in implementing adoption of the EH VBC program in the following key areas - Improve Access to Care; Improve preventive Wellness Visit rates; Improve Chronic Condition Management; Reduce avoidable IP & ER admissions and readmissions; Improve appropriate coding, documentation, and timely billing
- Align practice group on network quality performance goals
- Establish practice group's weekly, monthly operational goals to achieve annual performance goals
- Evaluate practice behavior change and quality performance against goals
- Measure and monitor practice population health management and present performance results to both EH and practice executive leadership
- Identify practice barriers and support practice with recommendations to surmount barriers to performance
- Change management driver: Partner with provider practices to drive sustainable operational and behavioral change that improves quality performance, patient outcomes, and VBC success.
- Monitor, document, and report practice progress; recommend next action based on determination of progress: escalate for network optimization action
- Enhance utilization of CareEmpower or other population health management tool to support practice population health management
- Facilitate implementation of Equality Health’s digital data retrieval and integration
- Support and training of all practices in the markets assigned, with feedback loops to the Practice Account Manager (PAM)
- Represent EH as the face of the organization within assigned markets, cultivating provider engagement, strengthening partnerships, and driving successful adoption of VBC strategies.
- Other job duties as assigned
Required Skills & Qualifications:
- Bachelor's degree in business, public health or a related field of study; or an equivalent of education and/or experience in healthcare delivery systems
- Must possess a valid driver's license, maintain reliable personal transportation, and be willing and able to travel extensively (up to approximately 75%) throughout assigned local and regional markets to support provider practices.
- Minimum of 3 years of experience in the healthcare industry, preferably in the provider practice setting: primary care/ specialty care practice management, medical assistance, quality (HEDIS/STARs), revenue cycle
- Minimum of 3 years of experience in the health care industry, preferably as a practice manager, coder, medical assistant, quality (HEDIS/STARs) analyst, or a revenue cycle analyst
- Minimum of 1 year of experience in Medicaid and Medicare value-based care and population health management
- Experience with HEDIS, STARs (Quality measures), and medical coding and billing (revenue cycle)
- Electronic Health /Medical Records (EHR/EMR) experience
- Demonstrated ability and experience to drive change: practice transformation, practice performance improvement
- Demonstrated ability to engage providers and support staff and drive performance to achieve a mutual patient population and care management goals
Highly Preferred Skills, Abilities & Qualifications:
- Practice Management experience
- Any Quality certifications (example: CPHQ – Certified Professional in Healthcare Quality or other)
- Medical Assistant credentials or experience
- EMR template-building ability and experience
Equality Health provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state, or local laws.
This policy applies to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absence, compensation, and training.