Director of Integration - Springfield, United States - Baystate Health

Baystate Health

Verified Company

Springfield, United States

3 weeks ago

Posted by:

Mark Lane

beBee recruiter

Description

Category(s): Allied Health Clinical Professional, Medical Practice Other

Full Time / Part Time:
Full-Time

Shift:
First

Under the direction of and in partnership with the Chief of Clinical Integration, the Director of Population Health & Clinical integration is accountable for the strategic and operational planning and execution of Baystate Health's Population Health and clinical integration strategies needed for success in value based care and achieving orchestrated access goals.

This includes oversight and management of Baystate's post-acute network, clinically integrated care model design to achieve access optimization, medical complexity program success, direct supervision of the BeHealthy ACO medicaid ambulatory care management teams, and medical management programming needed for success in value-based care and population health.

In doing so, he/she works to assure a comprehensive, cohesive, and coordinated approach to the care of patients over time, in multiple environments, and across the entire spectrum of healthcare services delivery both within and outside of BH.

He/She provides leadership in developing, planning, organizing, implementing, and evaluating continuum of care services respective to the goals of access, clinical quality, value, and satisfaction and works with clinical leadership across the health system and other outside entities to align strategies and tactics.

Along with the Director of Quality and Medical Management, he/she operationalizes programs aligned with the key drivers of success in value-based care including programs designed to manage and optimize medical management opportunities, address appropriate risk adjustment, quality management, and align programs to maximize success in value-based care.

The Director oversees ambulatory care coordination activities within Baystate's population health infrastructure and is responsible for the strategic design and implementation of clinical population health services delivered by BH and in coordination with other partner entities (e.g., Disease Management, Complex Case Management, Wellness/HEDIS STARs and Transitions of Care).

The Director will oversee the strategic direction and clinical operations of a robust Care Management team dedicated to the BeHealthy ACO that focuses on coordinating the overall care for identified patients at and among various clinics and physician practice sites, and across key partners such as post-acute, community, Behavioral health and LTSS partners.

This is accomplished through network development with community partners and the direct oversight of practice-based and centralized teams of a Nurse Care Managers, Care Coordinators, Social Workers, Recovery Coaches, and Community Health workers.

He/She will oversee the development of standard processes and workflows for care management activities that meet contractual requirements and include integration into the health systems population health platform.

Responsibilities:

Ability to lead large scale transformational change in health care at the organizational/system level and work effectively with all levels within and outside the organization, individual and team, across disciplines and geography
Provides strategic oversight and management of population health service teams within BH including ambulatory care management (e.g., Disease Management, Complex Case Management, Wellness/HEDIS STARs and Transitions of Care). He/She will provide direct oversight to the BeHealthy ACO care management teams and will provide integrative leadership for partner programs providing care to BH patients. This includes ensuring compliance with contractual obligations for BeHealthyACO care management activities.
Directs focused care management and disease management interventions targeted to improve patient and provider satisfaction, decrease costs, maximize quality and improve clinical outcomes. This includes the ability to develop appropriate protocols and guidelines
Develop and implement educational and professional development programs and curriculum across care management program staff (care managers (RN), community health workers, health coaches) to ensure continuing professional growth/advancement
Development and management of clinical integration and preferred provider networks for BH with key network partners including home health agencies, skilled nursing partners, community based organizations as well as primary and specialty care providers.
Orchestrates the development, implementation, and outcomes measurement of clinical programming and tactics to meet population health medical management targets (ie readmission strategies, transitions in care)
Management of Baystate Ambulatory Medical Complexity (RAF) team including development and implementation of strategies and processes to facilitate addressing chronic disease gaps and appropriate diagnosis capture. This includes clinician engagement and education, data analytics, proce