Job Description

The Provider Recruitment Directoris responsible for recruiting physicians and advanced practice providers (APPs) as well as adhere to best practices. This person's recruitment efforts will include physicians and APP's from a range of specialties and clinical practice levels into Privia Care Centers.

Qualifications

• Build and manage a steady pipeline of physicians and advanced practice providers APP’s to support our national provider recruiting function

• Proactively develop succession planning for upcoming physician and APP vacancies

• Analyze current state of physician and APP network and develop strategies to improve processes

• Maintain a network of clinicians and third parties involved in physician/APP recruitment and placement processes (i.e., firms, educational/residency programs, conferences, industry specific job boards/databases, email lists etc.)

• Source, screen and evaluate potential clinical candidates

• Develop/implement recruitment strategies for open positions
• Build and manage a steady pipeline of physicians and advanced practice providers APP’s to support our national provider recruiting function
• Proactively develop succession planning for upcoming physician and APP vacancies
• Analyze current state of physician and APP network and develop strategies to improve processes
• Maintain a network of clinicians and third parties involved in physician/APP recruitment and placement processes (i.e., firms, educational/residency programs, conferences, industry specific job boards/databases, email lists etc.)
• Source, screen and evaluate potential clinical candidates
• Develop/implement recruitment strategies for open positions
• Guide clinicians and Care Center hiring partners through the recruiting process
• Develop and execute physician and APP succession planning strategies with practice and market stakeholders
• Collaborate with Market Leadership, Performance, Implementation and Sales teams to manage the prioritization and ongoing hiring needs across Privia Care Centers with an emphasis on growth opportunities
• Partner with hiring managers in Privia Care Centers to understand practice needs and clinician preferences
• Advise clinical practices on regional compensation, benefit packages and ramp up times
• Arrange all interview processes and coordinate with each clinical practice on hiring processes
• Advise clinical practices on best practices for successful hiring
• Coordinate Care Center site visits, dinners, and other recruitment events as needed
• Attend local, regional, and national clinical recruitment and medical association conferences
• Present offers and negotiate compensation packages
• Assist with onboarding and new hire orientation as needed
• Ability to travel (20%)
• Other duties as assigned

The salary range for this role is $85,000.00-100,000.00 in base pay and exclusive of any bonuses or benefits (medical, dental, vision, life, and pet insurance, 401K, paid time off, and other wellness programs). This role is also eligible for a variable compensation plan and restricted stock units. The base pay offered will be determined based on relevant factors such as experience, education, and geographic location.

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Job Description

The Credentialing Specialist is responsible for all aspects of the credentialing, re-credentialing and privileging processes for all providers in Privia’s high-performance medical group.

Primary Job Duties:

• Follows documented process to ensure timely processing of Primary Source Verification completion for initial and recredentialing.
• Follows guidelines in alignment with all NCQA, CMS, and state requirements as related to the provider credentialing. 
• Works with both internal and external stakeholders to resolve complex provider credentialing issues.
• Supports special projects requiring knowledge of delegated and non-delegated health plan requirements
• Maintains up-to-date data (expireables) for each provider in credentialing databases and CAQH;; ensures timely renewal of licenses, certifications, COI’s etc.
• Maintains confidentiality of provider information
• Assist in managing the flow of information between internal stakeholders
• Coordinate and prepare reports under the direction and supervision of the manager
• Record and track credentialing statistics
• Other duties as assigned

Qualifications

• 1+ years experience in managed care credentialing Primary Source Verification
• Demonstrated skills in problem solving and analysis and resolution
• Must be able to function independently, possess demonstrated flexibility in multiple project management 
• Must comply with HIPAA rules and regulations

• An individual with the ability to communicate appropriately and effectively with practitioners, internal stakeholders, and providers; including sensitive and confidential information
• High level of attention to detail with exceptional organizational skills
• Exercise independent judgment in interpreting guidelines of applicable regulatory bodies.

The salary range for this role is $50,000.00-$55,000.00 in base pay and exclusive of any bonuses or benefits (medical, dental, vision, life, and pet insurance, 401K, paid time off, and other wellness programs). The base pay offered will be determined based on relevant factors such as experience, education, and geographic location.

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Job Description

The Privia+ Implementation Manager plays a key role in the Privia’s provider innovation programs. They are responsible for the successful implementation of the Privia+ suite of products and services. These premium solutions remove burdensome tasks from providers’ to-do lists, freeing them to focus on excellent patient care. The implementation manager is the first line of contact for the provider from sale to go-live, maintains regular check-ins, and ensures timely completion of all tasks. 

• Lead successful go-lives for Privia+ products

• Execute project plans, adhere to deadlines, and work to resolve blockers that threaten success

• Deliver training sessions on coding workflows, documentation requirements, and compliance standards for new providers

• Provide ongoing education and resources to address specific provider needs

• Serve as the primary point of contact for new providers during the implementation phase

• Maintain excitement and momentum from sale to go-live

• Provide go-live support as needed

• Work closely with clinical, operational, and billing teams to align coding services with overall organizational goals

• Configure and optimize coding workflows tailored to the provider’s specialty and organizational guidelines

• Test and validate coding systems to ensure accuracy and functionality for new providers

• Support providers through change management

• Collaborate regularly with SMEs, internally and externally, to ensure exceptional customer service

• Compile and provide feedback to internal and external teams

• Address and resolve any technical, procedural, or documentation issues during the implementation process

• Escalate complex issues to the appropriate teams for resolution when necessary

• Perform initial audits of provider documentation to assess alignment with coding standards.

• Provide constructive feedback to improve documentation practices and coding accuracy.

• Lead and participate in shadow coding processes as needed, providing feedback and support to improve coding accuracy and adherence to regulatory requirements

• Stay updated on regulatory changes and communicate updates to the providers as needed

• Maintain detailed records of the implementation process, including training sessions, audits, and feedback

• Develop and update documentation and resources to support future implementation.

• Perform other duties as assigned

Qualifications

• Bachelor's degree or equivalent preferred

• Certified Professional Coder (CPC) Required 

• 5+ years experience in E&M and specialty coding 

• Coding auditing experience preferred

• Knowledge of the healthcare industry

• Must comply with HIPAA rules and regulations

The salary range for this role is $75,000.00 - $92,000.00 in base pay and exclusive of any bonuses or benefits (medical, dental, vision, life, and pet insurance, 401K, paid time off, and other wellness programs). This role is also eligible for an annual bonus targeted at 15% and restricted stock units. The base pay offered will be determined based on relevant factors such as experience, education, and geographic location.

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Job Description

The ideal candidate will support the growth of Privia Health by assisting the Physician Development, New Provider Recruitment, and Business Development teams.  Additionally, this person will help support marketing and sales operations, with a focus on CRM data integrity.

Essential Job Duties:

• Review, clean, and analyze data for current and new markets in Salesforce, Privia’s Customer Relationship Management (CRM) system to provide analysis on Total-Available Market (TAM)

• Operational support to the Physician Development and New Provider Recruitment teams including but not limited to ongoing maintenance of our Customer Relationship Management (CRM) system data

• Perform other duties as assigned

Qualifications

• Pursuing Bachelor’s Degree, Junior year or above and minimum GPA of 3.0

• Superior organization and analytical skills with the ability to communicate clearly 

• Strong computer technology skills including, but not limited to, Microsoft Outlook, Microsoft Word, Excel, PowerPoint and Social Media outlets.

• Demonstrated ability to conduct Internet research in an efficient, productive manner. 

• Must comply with HIPAA rules and regulations 

Interpersonal Skills & Attributes:

• Excellent verbal and written communication skills, including superior grammar and proofreading skills

• Excellent interpersonal skills with the ability to engage at all levels of the organization

• Demonstrate a professional and adaptable demeanor with internal and external clients, including administrators, physicians, peers, and support staff

• Exhibit a high energy level, and demonstrate the ability to work as a team, with flexibility in work habits to schedule and meet the needs of the medical staff

• Proven track record of exceptional customer service skills

• The ability to multi-task, planning and prioritizing a large volume of detail-oriented work in accordance with changing deadlines

• The ability to work with minimum supervision, set priorities, and follow through to accomplish results

The salary range for this role is $15-$17/hr in base pay and exclusive of any bonuses or benefits. The base pay offered will be determined based on relevant factors such as experience, education, and geographic location.

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Job Description

The Coder+ Quality Assurance Specialist will be accountable for executing the quality assurance program related to CODER+ services provided by Privia Health. The QA Specialist will serve as an integral member of the CODER+ program team, responsible for partnering with vendor partners and internal coders to ensure high quality coding is being performed and that proper feedback is being given. This position will spend the majority of the time reviewing coders, educating coders, and working on various projects that involve coding and education. The ideal candidate will draw on existing expertise in primary care and specialty medical coding, billing and compliance with government and commercial payers and act as a coding resource within the team. The Quality Assurance Specialist will perform Evaluation and Management coding, procedure, ICD-10 and HCPC quality reviews as well as other projects related to physician coding. The ideal candidate demonstrates a thorough understanding of complex coding and reimbursement as they relate to physician practices and clinic settings.

Job Requirements:

• Apply appropriate coding classification standards and guidelines to medical record documentation for accurate coding
• Perform quality assessments of records, including verification of medical record documentation (electronic and handwritten)
• Perform quality assessments of coders completed work to validate standards are met
• Research and answer coding and coding workflow related questions for providers and clinic staff
• Meet with providers and clinic staff as needed
• Educate coders and other staff on appropriate coding guidelines
• Assist in development and ongoing maintenance of processes and procedures for each assigned client
• Collaborate with internal Privia+ and Privia teams
• Collaborate with vendor partners
• Follow coding guidelines and legal requirements to ensure compliance with federal and state regulatory bodies
• Assist in the Privia+ day-to-day coding/educational needs as needed
• Other duties as assigned

Qualifications

• 5+ years of provider medical coding experience across medical and surgical specialties
• 3+ years experience in coding audit or quality review work
• AAPC Certified Professional Coder (CPC) certification required
• CPMA preferred 
• Athena EMR experience preferred 
• Experience working in a physician practice setting strongly preferred
• Ability to work effectively with physicians, advanced practice providers (APP), practice staff, health plan/other external parties and Privia multidisciplinary team
• Extensive knowledge of official coding conventions and rules established by the American Medical Association (AMA), and the Center for Medicare and Medicaid Services (CMS) for assignment of diagnostic and procedural codes.
• Must comply with HIPAA rules and regulations
• Passion for efficiency and a drive to reduce redundancy
• Professional, clear, and concise oral and written communication
• Knack for prioritizing efficiently and multi-tasking
• Self-directed with the ability to take initiative
• Competent in maintaining confidential information
• Strong team player with ability to manage up members of team to encourage partnership and cooperation with clinic staff

The salary range for this role is $65,000.00 to $75,000.00 in base pay. This role is also eligible for an annual bonus targeted at 10% based on the performance for the role. The base pay offered will be determined based on relevant factors such as experience, education, and geographic location.

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Job Description

As Privia Health continues to grow, we are seeking a proactive pipeline of interested, qualified candidates.

Privia is looking for a Growth Director to join our rapidly growing sales team. The Growth Director is responsible for achieving targets for the overall recruitment of providers into Privia Medical Group (PMG). The Director is a sales professional with demonstrated experience closing complex business deals, consistently meeting and exceeding goals.

80% territory travel required 

Primary Job Duties: 

• Segment a market/region and develop a target list of independent primary care doctors and specialists

• 70% new business prospecting through in-person initial sales meetings and presentations with physicians 

• Follow up with interested physicians and manage opportunities to close

• Track activities, leads, and pending deals in SalesForce and participate in weekly sales calls

• Contribute new ideas and share best practices with national sales team

• Provide ongoing relationship and sales support to recruited practices

• Work with the varied constituencies in Sales and Marketing to drive lead generation with top accounts and new opportunities

• Establish relationships with local partners and distributors

• If necessary, stand up a new market for Privia

• Perform other duties as assigned

Qualifications

• Bachelor's degree and advanced degree a plus

• 5+ years complex sales or healthcare consulting experience in a highly competitive market

• Demonstrated ability as an individual contributor in a highly competitive sales environment  

• Experience exceeding sales targets with proven ability to generate in excess of $1 Million in sales

• Must provide reliable transportation

• Must comply with all HIPAA rules and regulations

Interpersonal Skills & Attributes:

• Sales orientation

• Proven ability to qualify and follow-up on leads from various sources

• Demonstrated ability to think of creative tactics to drive closure and shorten sales cycles

• Highly self-motivated and independently driven

• Deadline and results oriented

• Tech-orientated

• Motivated, metrics-driven self starter with an excellent work ethic 

• Excellent time management, communication, analytical, and organizational skills

The salary range for this role is $85,000.00-100,000.00. This role is also eligible for a variable compensation plan with an additional target of $85,000.00-100,000.00 and restricted stock units.The base pay offered will be determined based on relevant factors such as experience, education, and geographic location.

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Job Description

The senior Medicare Program Analyst will work cross-functionally within the team, helping develop a purpose-driven analytics platform to maximize our analytics capabilities and performance. This role's primary emphasis is building, automating, and optimizing technical processes for running Medicare Value-Based Care Program MVBCP) analytics.

Primary Job Duties:

• Develop proprietary solutions to provide the business with the best analytics to drive success in existing and new contracts
• Develop integration and automation of MVBC analytics processes to achieve superior service in providing insights to internal and external stakeholders
• Enable the MVBC team to achieve higher efficiency in performing analyses and running reports by:
  • Improving the performance and scalability of databases, SQL scripts, and SAS programs
  • Designing, building, and running ETL programs and automation scripts for extracting, cleaning, transforming, and loading claims, EMR, clinical, and third-party data using SAS (9.4) and SQL (Snowflake)
  • Collaborating with the team members to design ETL & automation workflows
  • Ensuring data integrity, data accuracy, and completeness by developing Quality Assurance (QA) checks
  • Evaluating and improving existing QA checks
  • Documenting technical processes for future reference
  • Providing expertise to team members in technical aspects of building healthcare analytical solutions
• Assume leadership in representing the MVBC team in organization-wide infrastructure-related projects such as database, platform, and application migration
• Collaborate closely with IT leadership, engineers, and 3rd parties to build and enhance business analytics to support Privia Health’s VBC business
• Learn and understand the Medicare regulatory landscape related to healthcare data, analytics, Shared Savings programs, and Accountable Care Organizations (ACO)

Qualifications

• Proven record in building automation, ETL, and scalable analytics using SAS and SQL
• Strong experience with SAS and SQL required
• Bachelor’s Degree preferred in healthcare or a quantitative major (e.g., public health, engineering, analytics, economics, actuarial sciences, statistics, healthcare information systems) OR relevant equivalent experience preferred 
• Experience working at a health plan, hospital system, ACO, provider organization, consulting firm, technology start-up, or previous analytics experience and capabilities preferred
• Experience with Snowflake environment preferred

Interpersonal Skills & Attributes:

• Communicates complex information and concepts. Creates clarity and adjusts style to the expertise of the audience
• First thing first, prioritizes based on the needs of the MVBC team and business
• Outcomes-driven, delivers with impeccable planning and time management
• Performance-driven, keeps the team’s goals at the forefront and prioritizes daily         activities to meet those goals
• Comfortable in a rapidly evolving environment
• Highly collaborative and effective across an organization and amongst multiple stakeholders
• Must comply with HIPAA rules and regulations

The salary range for this role is $82,500.00 to $110,000.00 in base pay and exclusive of any bonuses or benefits. This role is also eligible for an annual bonus targeted at 15% and restricted stock units based on performance in the role. The base pay offered will be determined based on relevant factors such as experience, education, and geographic location.

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Job Description

The Systems Optimization Manager will be responsible for optimizing and assisting with ongoing management of operational processes that span across our technology platform, especially Salesforce, aligning them with Privia Health’s mission to optimize healthcare delivery through an integrated and efficient approach. The Systems Manager leads requirements gathering, synthesizes business needs into actionable user stories, and collaborates with leadership across departments to enforce process governance. This role requires a blend of technical expertise, leadership skills, and strong cross-functional communication abilities to successfully manage complex processes and drive organizational improvement initiatives.

• Serve as the central point of contact for managing and overseeing cross-functional processes across our technology platforms, especially Salesforce, ensuring these align with the standards and goals of the company.
• Develop and implement governance structures that ensure clear accountability for operational processes across all teams within Privia Health.
• Facilitate regular governance meetings to drive decisions, build consensus, and prioritize key initiatives across teams involved in supporting our Care Centers. Set governance standards that dictate the way we use and interact with our CRM platform.
• Lead discovery and requirements refinement sessions to uncover customers’ business, functional, and technological needs.
• Synthesize requirements into user stories and partner with the Product team for solution design and build
• Perform fit-gap analysis between our various operational tools and client requirements
• Work with leadership across Privia’s various functions (including Practice Operations, Revenue Cycle Management, and Clinical Operations) to develop a unified strategy for process governance and improvement.
• Act as a liaison across all departments to ensure that governance initiatives and process improvements are effectively communicated, implemented and adhered to.
• Support teams in implementing new processes and monitoring their effectiveness to ensure continuous alignment with Privia’s goals. Develop reporting to track these success measures.
• Establish performance metrics and service level agreements that hold teams accountable to the highest level of operational excellence
• Perform other duties as assigned

Qualifications

• Bachelor’s degree in Business, Healthcare Administration, or a related field preferred or relevant equivalent experience.
• 3+ years of experience in business analysis or process improvement, preferably in a healthcare setting or with experience in healthcare governance.
• Strong understanding and experience with Salesforce
• Familiarity with healthcare operations, especially around practice management, care delivery, and revenue cycle management.
• Strong background in conducting gap analysis, process optimization, and implementing governance structures.
• Proven ability to work collaboratively across clinical, operational, and administrative teams to achieve business goals. 
• Excellent analytical and problem-solving skills, with the ability to turn business requirements into actionable solutions.
• Strong communication skills with experience presenting to leadership and stakeholders at various levels.
• Familiarity with project management methodologies, such as Agile, is a plus.

The salary range for this role is $105,000 to $125,000 in base pay and exclusive of any bonuses or benefits. This role is also eligible for an annual bonus targeted at 15% & restricted stock units. The base pay offered will be determined based on relevant factors such as experience, education, and geographic location.

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Job Description

The Coder+ Quality Assurance Specialist will be accountable for executing the quality assurance program related to CODER+ services provided by Privia Health. The QA Specialist will serve as an integral member of the CODER+ program team, responsible for partnering with vendor partners and internal coders to ensure high quality coding is being performed and that proper feedback is being given. This position will spend the majority of the time reviewing coders, educating coders, and working on various projects that involve coding and education. The ideal candidate will draw on existing expertise in primary care and specialty medical coding, billing and compliance with government and commercial payers and act as a coding resource within the team. The Quality Assurance Specialist will perform Evaluation and Management coding, procedure, ICD-10 and HCPC quality reviews as well as other projects related to physician coding. The ideal candidate demonstrates a thorough understanding of complex coding and reimbursement as they relate to physician practices and clinic settings.

Job Requirements:

• Apply appropriate coding classification standards and guidelines to medical record documentation for accurate coding
• Perform quality assessments of records, including verification of medical record documentation (electronic and handwritten)
• Perform quality assessments of coders completed work to validate standards are met
• Research and answer coding and coding workflow related questions for providers and clinic staff
• Meet with providers and clinic staff as needed
• Educate coders and other staff on appropriate coding guidelines
• Assist in development and ongoing maintenance of processes and procedures for each assigned client
• Collaborate with internal Privia+ and Privia teams
• Collaborate with vendor partners
• Follow coding guidelines and legal requirements to ensure compliance with federal and state regulatory bodies
• Assist in the Privia+ day-to-day coding/educational needs as needed
• Other duties as assigned

Qualifications

• 5+ years of provider medical coding experience across medical and surgical specialties
• 3+ years experience in coding audit or quality review work
• AAPC Certified Professional Coder (CPC) certification required
• CPMA preferred 
• Athena EMR experience preferred 
• Experience working in a physician practice setting strongly preferred
• Ability to work effectively with physicians, advanced practice providers (APP), practice staff, health plan/other external parties and Privia multidisciplinary team
• Extensive knowledge of official coding conventions and rules established by the American Medical Association (AMA), and the Center for Medicare and Medicaid Services (CMS) for assignment of diagnostic and procedural codes.
• Must comply with HIPAA rules and regulations
• Passion for efficiency and a drive to reduce redundancy
• Professional, clear, and concise oral and written communication
• Knack for prioritizing efficiently and multi-tasking
• Self-directed with the ability to take initiative
• Competent in maintaining confidential information
• Strong team player with ability to manage up members of team to encourage partnership and cooperation with clinic staff

The salary range for this role is $65,000.00 to $75,000.00 in base pay. This role is also eligible for an annual bonus targeted at 10% based on the performance for the role. The base pay offered will be determined based on relevant factors such as experience, education, and geographic location.

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