Clinical Value and Transformation Architect

Job Details

Job Description

The Quality Program and Value Architect serve as a strategic leader responsible for optimizing Jeffersons performance across valuebased care programs quality incentive models and clinical documentation accuracy. This role ensures the organization captures all eligible revenue from valuebased contracts and payer programs by driving operational excellence financial modeling and quality outcome improvement. The Architect partners closely with clinical operational finance population health and analytics teams to design and execute strategies that improve quality scores enhance patient outcomes and maximize financial performance.

Essential Functions

• Interacts with co-workers visitors and other staff consistent with the values of Jefferson.
• Lead the evaluation design and optimization of quality programs and valuebased care initiatives to ensure Jefferson achieves maximum allowable reimbursement.
• Develop and maintain financial models that forecast program performance incentive opportunities and risk exposure across valuebased contracts.
• Identify gaps in quality performance documentation accuracy and utilization patterns; translate findings into actionable interventions.
• Partner with Clinical Efficiency teams to optimize clinical documentation workflows ensuring accurate capture of patient acuity case mix index and DRG assignment.
• Collaborate with analytics revenue cycle population health and IT stakeholders to build dashboards tools and governance structures that support sustained improvement.
• Monitor regulatory updates contract changes and payer program methodologies to ensure alignment of enterprise strategies.
• Drive initiatives that reduce unwarranted variation improve patient outcomes and strengthen financial returns from quality and valuebased programs.

Competencies:

• Deep expertise in valuebased care models quality program design and payer incentive structures.
• Strong financial modeling capability including forecasting scenario analysis and opportunity sizing.
• Knowledge of clinical quality measures documentation standards utilization management and risk adjustment.
• Strong analytical proficiency with tools such as SQL Tableau Power BI and predictive modeling platforms.
• Ability to communicate complex concepts effectively to clinical and operational leaders.
• Excellent stakeholder engagement crossfunctional collaboration and changemanagement skills.

Education:

Bachelors degree in healthcare Finance Information Technology or a related field. Masters degree preferred.

AND

Experience:

10 years of experience in quality improvement valuebased care program management healthcare finance clinical documentation integrity or related fields. Leadership experience required.

Minimum Certifications Registration or License Requirements:

Preferred but not required: CPHQ CPC CCDS CRCR or certifications related to quality coding or documentation integrity.

Work Shift

Worker Sub Type

Employee Entity

Primary Location Address

Nationally ranked Jefferson which is principally located in the greater Philadelphia region Lehigh Valley and Northeastern Pennsylvania and southern New Jersey is reimagining health care and higher education to create unparalleled value. Jefferson is more than 65000 people strong dedicated to providing the highest-quality compassionate clinical care for patients; making our communities healthier and stronger; preparing tomorrows professional leaders for 21st-century careers; and creating new knowledge through basic/programmatic clinical and applied research. Thomas Jefferson University home of Sidney Kimmel Medical College Jefferson College of Nursing and the Kanbar College of Design Engineering and Commerce dates back to 1824 and today comprises 10 colleges and three schools offering 200 undergraduate and graduate programs to more than 8300 students. Jefferson Health nationally ranked as one of the top 15 not-for-profit health care systems in the country and the largest provider in the Philadelphia and Lehigh Valley areas serves patients through millions of encounters each year at 32 hospitals campuses and more than 700 outpatient and urgent care locations throughout the region. Jefferson Health Plans is a not-for-profit managed health care organization providing a broad range of health coverage options in Pennsylvania and New Jersey for more than 35 years.

Jefferson is committed to providing equal educational and employment opportunities for all persons without regard to age race color religion creed sexual orientation gender gender identity marital status pregnancy national origin ancestry citizenship military status veteran status handicap or disability or any other protected group or status.

Benefits

Jefferson offers a comprehensive package of benefits for full-time and part-time colleagues including medical (including prescription) supplemental insurance dental vision life and AD&D insurance short- and long-term disability flexible spending accounts retirement plans tuition assistance as well as voluntary benefits which provide colleagues with access to group rates on insurance and discounts. Colleagues have access to tuition discounts at Thomas Jefferson University after one year of full time service or two years of part time service. All colleagues including those who work less than part-time(including per diemcolleagues adjunct faculty and Jeff Temps) have access to medical (including prescription) insurance.

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