Director, Value Delivery

firsthand supports individuals living with SMI (serious mental illness). Our holistic approach includes a team of peer recovery specialists, benefits specialists and clinicians, which focuses on meeting each individual where they are and walking with them side by side as a trusted guide, partner, and first call on their journey to wellness.

firsthand's team members use their lived experience to build trust with these individuals and support them in obtaining socio-economic assistance and in reconnecting to primary and behavioral care. Support like this creates substantial savings for managed care organizations (Medicaid providers) and taxpayers by decreasing inappropriate healthcare utilization. This enables us to build solutions that scale and, as a result, change the way our society supports those most impacted by SMI.

We are cultivating a team of deeply passionate problem-solvers to tackle significant and complex healthcare challenges with us. This is more than a job—it's a calling. Every day, you will engage in work that resonates with purpose, gain wisdom from motivated colleagues, and thrive in an environment that celebrates continuous learning, creativity, and fun.

firsthand’s Activation team serves individuals in the first 60-90 days of being engaged. The individuals firsthand serves often are not regularly plugged into quality care. In this activation phase, firsthand aims to understand an individual’s holistic clinical needs so that individuals can get plugged into the right benefit and care programs for their recovery journey. The Director will be responsible for the analytics and operational performance management for appropriate clinical documentation.

As a Director of Value Delivery, you will:

• Be responsible for the performance management and strategy development for Medicaid and Medicare risk adjustment at firsthand, partnering closely with CDI, Medical Records, Billing, and other Activation Team leaders
• Manage, coach and develop firsthand’s Clinical Documentation Manager
• Partner with Product, Engineering, and Data teams to influence and execute Technology capability roadmaps that impact or enable Clinical Documentation
• Proactively communicate Clinical Documentation performance, opportunities and risks to firsthand’s executive Leadership and Finance teams
• Collaborate with Community Operations leadership to guide performance management for Health Guide (HG) visit scheduling and other key metrics (e.g., condition addressal)
• Partner with Compliance and Activation teams to develop and manage company-wide policies for risk adjustment and coding practice to ensure clinical documentation integrity
  
  
  

You will be a good fit if you have

• At least 8-10 years of professional experience
• Strong communication, interpersonal, and organizational skills
• Highly effective at directly managing or influencing high-performing teams
• Working knowledge of performance managing risk adjustment programs
• Strong individual-centered service orientation
• Ability to manage ambiguity, work in a fast-paced environment, and collaborate cross-functionally
  
  
  

The required experience you bring to this role includes:

• Experience in healthcare, plan or provider operations and relations or related experience
• Comfortable adapting to and managing ambiguity
• Demonstrated track record of accountability working in a highly cross-functional, matrixed, fast-paced environment with humility and a bias for action
• Strong analytical and logical skills paired with familiarity with BI tools, such as Snowflake, MySQL, QuickSight, etc
• Expertise in Medicare risk adjustment methodologies (CMS-HCC model)
  
  
  

Bonus points for:

• Experience with Medicaid risk adjustment models, such as CDPS and ACG
• Bachelors or Masters Degree in business, finance, management, analytics, or equivalent
• Professional experience in high-growth startup environments
• Experience serving those with complex medical conditions, and preferably SMI and/or SUD
  
  
  

Benefits

For full-time employees, our compensation package includes base, equity (or special incentive program for clinical roles) and a bonus potential. Our benefits include physical and mental health, dental, vision, 401(k) with a match, 16 weeks parental leave for either parent, flexible vacation, and a supportive and inclusive culture.

Unfortunately, we are not able to offer sponsorship at this time.

Vaccination Policy

Employment with firsthand is contingent upon attesting to medical clearance requirements, which include, but may not be limited to: evidence of vaccination for/immunity to COVID-19, Hepatitis B, Influenza, MMR, Chickenpox, Tetanus and Diphtheria. All employees of firsthand are required to receive these vaccinations on a cadence/frequency as advised by the CDC, whereas not otherwise prohibited by state law.

New hires may submit for consideration a request to be exempted from these requirements (based on a valid religious or medical reason) via forms provided by firsthand. Such requests will be subject to review and approval by the Company, and exemptions will be granted only if the Company can provide a reasonable accommodation in relation to the requested exemption. Note that approvals for reasonable accommodations are reviewed and approved on a case-by-case basis and availability of a reasonable accommodation is not guaranteed.