Manager, Care Management and Complex Discharge Planning at Community Care Cooperative

Boston, Massachusetts, United States -

Full Time

Start Date

Immediate

Expiry Date

24 Aug, 26

Salary

109250.0

Posted On

26 May, 26

Experience

2 year(s) or above

Remote Job

Yes

Telecommute

Yes

Sponsor Visa

Skills

Care Management, Complex Discharge Planning, Supervisory Experience, Performance Monitoring, Case Management, Interdisciplinary Team Leadership, Clinical Auditing, Stakeholder Management, Data Analysis, Medicaid Population Care, Microsoft Office, Electronic Health Records, Population Health Platforms, Interpersonal Communication, Conflict Resolution, Regulatory Compliance

Industry

Hospitals and Health Care

Description

Title: Manager, Care Management and Complex Discharge Planning Organization Summary: Community Care Cooperative (C3) is a 501(c)(3) non-proﬁt, Accountable Care Organization (ACO) governed by Federally Quality Health Centers (FQHCs). Our mission is to leverage the collective strengths of FQHCs to improve the health and wellness of the people we serve. We are a fast-growing organization founded in 2016 with nine health centers and now serving hundreds of thousands of beneﬁciaries who receive primary care at health centers and independent practices across Massachusetts. We are an innovative organization developing new partnerships and programs to improve the health of members and communities, and to strengthen our health center partners. Job Summary: The Manager, Care Management and Complex Discharge Planning is responsible for daily management of the C3 Care Management Program which includes enhanced care coordination activities of MassHealth (Pediatric, Adult and Maternal Health) Member Populations. This includes day- to-day mentoring and oversight of an interdisciplinary Care Management team comprised of RN care managers, Behavioral Health care managers, and Community Health Workers. In addition, the Manager provides performance oversight to FQHC/APP (Aﬃliated Participating Provider) Care Management Teams to ensure care management services are delivered in a high-quality, cost-eﬀective manner. This position will oversee the Complex Discharge Planner role, which is responsible for supporting complex discharge planning across all FQHCs and APPs to reduce readmissions and improve continuity of care. The manager is required to have a proﬁcient understanding of MassHealth requirements to ensure care management workﬂows are implemented, in compliance with both federal and state regulations. The manager works closely with the Director of Care Management and is responsible for performance and operational management of FQHCs/APPs participating in care management. Though this role is primarily “Hybrid,” it does require occasional oﬃce-based work in addition to in-person FQHC/APP- facing meetings. Responsibilities: * Assess and monitor team performance using program metrics, data, and management reports to assess caseloads, engagement rates, outcomes, and other process measures * Using data and managerial tactics, the manager will monitor staﬀ performance, including opportunities to improve and maintain performance standards * In collaboration with the Director of Care Management, the manager will develop, monitor, and report performance improvement needs of staﬀ and FQHC/APPs * Perform chart audits, provide staﬀ, and group supervision, and complete performance reviews, including mid-year and annual goal setting * Address operational needs including vacancies, participate in the hiring of staﬀ, manage the onboarding, orientation, and training process, as well as manage Personal Time Oﬀ (PTO) coverage * Ensure staﬀ are informed of policies and procedures and care management/program workﬂows * Support the development of training content, including workﬂow updates that reﬂect most current MassHealth / CMS requirements, and participate in delivering training * Build eﬀective relationships with all external stakeholders including our primary customer, FQHCs and APPs * Be ﬁrst point of contact for urgent needs, such as staﬀ managing complex patient issues/complex discharge plans member complaint and grievance issues pertaining to care management and escalating to Director/leadership as appropriate * Prepare CM performance material (PowerPoint) tailored to each FQHC/APP or aggregated for meetings such as monthly clinical performance reviews * Attend monthly FQHC/APP clinical performance meetings and ACO meetings, present care * management program performance data, as well as make recommendations on areas of improvement * Monitor performance trends and lead structured improvement initiatives for FQHCs and APPs not meeting targets * Be well-versed in understanding technology tools that support the care management program, including the care management platform and Health Related Social Needs (HRSNs) screening tool * Ensure special initiatives such as HRSNs and Care Needs Screening (CNS) processes are integrated into care management workﬂows * Facilitate clinical rounds, coordinate/attend complex discharge planning case discussions and participate in care management clinical forums * Special projects and other duties assigned Required Skills: * 3-5 years of supervisory experience in care management in a managed care environment; experience working with a Medicaid population is strongly preferred * Pediatric, obstetrics, maternal/newborn experience highly desired * Experience using Word Oﬃce products (Excel, Word, PowerPoint) Desired Other Skills: * Familiarity with MassHealth ACO Program, Medicare Risk Contracts (REACH, MSSP, ACO-Flex) * Familiarity with Federally Qualiﬁed Health Centers (FQHCs) or Community-Based Practices * Demonstrated success in leading a multi-disciplinary team, including communicating and working with Health Centers, providers, primary care teams, nurses, Community Health Workers, and other organizations/programs such as SSOs (Social Service Organizations), and CSPs (Community Support Programs) * Ability to navigate ambiguity and utilize clinical expertise to solve complex problems * Ability to understand and interpret program and staﬀ performance data analysis * Experience working with patients with chronic medical, behavioral, and social health needs * Must be ﬂexible and adaptable to change * Must demonstrate excellent interpersonal communication skills, written and presentation skills * Familiarity with managing data, reporting, and using data driven reports to inform decision making and performance * Ability to positively inﬂuence others with respect and compassion, and the ability to orient, motivate and build a cohesive team * Experience motivating, inspiring, and building consensus across diverse staﬀ * Experience using appropriate technology, such as computers and Virtual Meeting Rooms for work-based communication * Experience or familiarity working with CTC Epic/Epic, other EHRs, or Population Health Platforms (i.e., Arcadia) * Experience with anti-racism activities, and/or lived experience with racism is highly preferred Qualiﬁcations: * Bachelor’s or higher degree in nursing with Massachusetts RN Licensure or Master’s degree in social work (LMHC, LCSW, LICSW) with MA state Licensure * Case Management certiﬁcation preferred * A valid driver's license and provision of a working vehicle ** In compliance with Infection Control practices per Mass.gov recommendations, we require all employees to be vaccinated consistent with applicable law. **

Responsibilities

Manage the daily operations of the Care Management Program and oversee an interdisciplinary team to ensure high-quality care coordination for MassHealth members. Lead complex discharge planning efforts and monitor performance metrics for FQHCs and affiliated providers to reduce readmissions.