Program Specialist, CMMI Programs

Reporting directly to the Center for Medicare and Medicaid Innovation (CMMI) Program Manager, the Program Specialist will be a pivotal contributor to the operational excellence and strategic growth of our CMMI initiatives. This role is responsible for the intricate management and refinement of core program processes, ensuring seamless execution across all facets of CMMI models (LEAD & REACH). The Specialist will play a key role in analyzing program performance, identifying opportunities for optimization, and collaborating with diverse internal teams to implement innovative solutions that enhance engagement and outcomes within the CMMI model  framework. This position is central to translating strategic vision into operational reality, driving the continuous improvement and successful scaling of CMMI models.

Candidates should be comfortable working remotely from anywhere within the US, across all US time zones.

Primary Duties

Working and supporting day-to-day ACO REACH & LEAD processes and operations:

• Manage Zendesk incoming/outgoing communications for the CMMI team, responsible for all Zendesk tickets, escalating tickets as needed to the appropriate person/team

• Find and build out solutions in Monday.com for any CMMI process and operations needs (Growth, SVA, Contacts, Practice lists, Provider lists, CMS tickets, etc.)

• Utilize Medicare reports from 4i (quality, financial, claims reduction files, SVA response files) to generate reports so actionable insights and opportunities for improvement can be identified

• Utilize reports, calendars, and internal tools (Tableau, Snowflake) to build out internal and external decks for Contract and Resource Meetings and Performance and Resource Meetings

• Utilize insights, opportunities, and calendars to draft and maintain the company LEAD newsletter and its distribution list

• Manage the Beneficiary Zoom Voicemail for the CMMI team, ensuring that beneficiary questions are answered and logged for tracking and documentation purposes in Monday.com

Serve as a trusted planner, organizer, and executor for the CMMI team:

• Plan in Monday.com based on the CMMI programs calendar distributed by CMS so all deadlines are scheduled and met, both internally and externally

• Maintain CMMI programs Google Drive folders, prioritizing organization and appropriate access

• Act as a thought partner in opportunities for CMMI process development, needs, or gaps

• Provide suggestions and recommendations to ambiguous problems that align with program goals

• Think critically and move work forward without clearly defined or outlined next steps

Act as a researcher and advisor for the CMMI team's special projects and cross-functional initiatives:

• Contribute to broader, interdepartmental projects and meetings, including Field Team trainings, support, and inbound questions, as well as Project Turnkey support and coordination

• Communicate statuses on operations and keep stakeholders informed on any progress and roadblocks

• Develop implementation plans, communications, and rollout of approved necessary BE/BEIs (Telehealth)

• Provide details and insights during CMMI team meetings based on the CMS ACO LEAD newsletter, with emphasis on communicating when reports and funds are expected to be released, upcoming changes within the program, and important deadlines

• Serve as a resource to the PTS team to assist in addressing practice needs tied to CMMI operations

Minimum Qualifications

• Bachelor’s degree in a relevant field

• 3+ years of progressive healthcare experience

• Thrives in a fast-paced environment and manage multiple priorities

• Familiar with project management tools such as Monday.com

• Experience in data analytics using Excel or Google Sheets

• Willingness to travel as needed to the company’s headquarters and other offsite meetings (less than 10% across the year anticipated)

Preferred KSA's

• Knowledge of CMS VBC programs

• Can effectively adapt communication style based on audience needs

• Frequently and effectively collaborates cross functionally

• Exceptional written and verbal communications skills

• Snowflake experience

• Tableau experience

• Self-starter with strong interpersonal skills

• Proven ability to coordinate and facilitate new ideas into action while collaborating across multiple, dynamic, projects and teams

Physical Requirements

• Sitting for prolonged periods of time. Extensive use of computers and keyboard. Occasional walking and lifting may be required.

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Who We Are

The company PBC, a public benefit corporation, exists to empower the most transformational part of our health care landscape - independent primary care. We were founded in 2014, and since then, we've become the largest network of independent primary care in the country - helping practices, health centers and clinics deliver better care to their patients and thrive in value-based care. Additionally, by creating value-based contracts across a wide variety of health plans, we aim to flip the script on the traditional fee-for-service model. Our work strengthens continuity of care, aligns incentives and ensures primary care physicians are paid for what they do best - keeping patients healthy. If you want to help create a health care system that is good for patients, good for practices and good for society - and if you're eager to join a collaborative, inclusive and remote-first culture - you've come to the right place.

What Does This Mean for You?

At the company PBC, you will be part of a creative culture that is driven by a passion for tackling complex issues with respect, open-mindedness and a desire to learn. You will collaborate with team members who bring a wide range of experiences, interests, backgrounds, beliefs and achievements to their work - and who are all united by a shared passion for public health and a commitment to the company mission.

In addition to time off to support work-life balance and enjoyment, we offer the following comprehensive benefits package designed for the overall well-being of our team members:

Flexible work schedules and the ability to work remotely are available for many roles

Health, dental and vision insurance paid up to 80% for employees, dependents and domestic partners

Robust time-off plan (21 days of PTO in your first year)

Two paid volunteer days and 11 paid holidays

12 weeks paid parental leave for all new parents

Six weeks paid sabbatical after six years of service

Educational Assistant Program and Clinical Employee Reimbursement Program

401(k) with up to 4% match

Stock options

And much more!

At the company PBC, we don’t just accept differences, we celebrate them! We strive to attract, develop and retain highly qualified individuals representing the diverse communities where we live and work. The company is committed to creating a diverse environment and is proud to be an equal opportunity employer. Employment policies and decisions at the company are based on merit, qualifications, performance and business needs. All qualified candidates will receive consideration for employment without regard to age, race, color, national origin, gender (including pregnancy, childbirth or medical conditions related to pregnancy or childbirth), gender identity or expression, religion, physical or mental disability, medical condition, legally protected genetic information, marital status, veteran status, or sexual orientation.