- 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, process improvement, and workflow optimization across all lines of at risk business
- Along with the Chief of Clinical Integration, works collaboratively with service line clinical leaders and population based medical directors to create and execute standardized, cross continuum, technology-enabled organized models of chronic disease care in support of executing on a vision of orchestrated access to health
- Providers direct strategic and program oversight to the Mobile Health Equity Program (Wellness on Wheels) to deliver integrated health equity programming throughout the tri-county region. This includes the training of allied health professionals on delivering community health to underserved communities through the practical application of a curriculum of cultural humility and community outreach and engagement
- Creates and facilitates the interdisciplinary team process to ensure comprehensive care delivery and coordination across the continuum for patients and their families
- Act as a liaison between care management managers at physician practices, facilities, and managed care organizations to resolve continuum of care issues related to patient care. Develop and maintain positive working relationships with and between physicians, their clinical office staffs, the clinical staffs of managed care plans and PHOs (Baycare), the skilled nursing facility network, home health network, behavioral health and other community partners..
- Analyze population health data and trends, including quality and efficiency reporting, to design appropriate reporting and develop appropriate strategies to improve performance
- Demonstrated program/project management and data analysis skills in population health management, including population health analytics, disease and medical management, and financial optimization
- Minimum of 10 years related job experience required.
- Healthcare experience with Health system, Accountable Care Organizations (ACOs), or Physician Hospital Organizations (PHOs) in value-based care agreements.
- Experience in the redesign of systems and care management is required. Knowledge of chronic conditions, evidence-based guidelines, prevention, and wellness. Knowledge and experience with performance excellence and lean practices to improve quality and processes
- Masters degree required - in lieu of education may consider candidates with experience currently matriculated in Masters degree program
- Experience with medical management and data analytics to support population health0
- Experience with integrating data and technologies into clinical programming and workflows.
- Must be comfortable operating in a collaborative, matrixed leadership environment. Must possess strong organizational skills
- Ability to understand and analyze quality and efficiency data. Can multi-task, prioritize own work and coordinate the work of other departments within and outside of the organization to meet population health goals and integrate care transformation.
- Capacity to work strategically, closely, and effectively with practice leaders and physicians, care managers/coordinators, hospital administration, and information technology teams.
- Expertise and demonstrated success with large scale change management initiatives.
- Demonstrated presentation skills, including the ability to communicate complex concepts in an effective manner.
- Capacity to facilitate meetings with groups of various size and knowledge.
- Ability to handle situations which often require the use of tact and diplomacy
- Able to operationalize care model redesign within a matrixed environment including clinical teams, ambulatory operations, finance, payors, and IT
- Understanding of how to operationalize on key drivers of value-based care success including medical management, financial risk methodologies, risk adjustment capture, HEDIS quality outcomes, and care management.
-
Physician Assistant
4 days ago
Comprehensive Rehab Consultants Agawam, United States Part timeThe future of healthcare relies on the brightest minds and biggest hearts. Join us and be part of the team building tomorrow's healthcare. Work for a fun, fast-growing company that is revolutionizing the way skilled nursing facility (SNF) care is delivered. We pride ourselves on ...
-
Director Of Integration
4 weeks ago
Baystate Health Springfield, United StatesReq#: R30678 · 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 i ...
-
Clinical Pharmacy Coordinator
1 day ago
Trinity Health Springfield, United States**Employment Type:** · Full time · **Shift:** · Day Shift · **Description:** · Mercy Medical Center, Springfield, MA/Johnson Memorial Hospital, Stafford Springs, CT · Come and join our dedicated teams of pharmacy professionals. You would plan, develop, organize, educate, and coor ...
-
PGY2 Ambulatory Pharmacy Resident R29965
4 weeks ago
Baystate Health Springfield, United StatesReq#: R29965 · Category(s): Residents, Interns, Fellows, Pharmacist Resident · Full Time / Part Time: Full-Time · Shift: First · Summary: · The PGY-2 Pharmacy Residency is a twelve-month stipend-based program designed and structured to provide a second year pharmacy resident with ...
-
Trinity Health Corporation Springfield, United StatesEmployment Type: · Full time · Shift: · Day Shift · Description: · Come help lead our Pharmacy team at Mercy Medical Center, a member of Trinity Health Of New England · Position Purpose · Oversees and supervises the clinical operations of the Pharmacy Department with regard to th ...
-
Pediatric Orthopaedic Surgeon
5 days ago
Shriners Childrens Hospital Springfield, United StatesCompany Overview · Shriners Children's is a family that respects, supports, and values each other. We are engaged in providing excellence in patient care, embracing multi-disciplinary education, and research with global impact. We foster a learning environment that values evidenc ...
-
Addiction & Recovery Clinician
1 week ago
Mental Health Association - Western MA Springfield, Massachusetts, United States PermanentMHA is hiring immediately for an Addiction & Recovery Clinician for our BestLife Behavioral Health Clinic. The Addiction & Recovery Clinician will work in a community behavioral health and addiction setting, providing services to individuals experiencing a mental health and/or su ...
-
Registered Nurse Coordinator
4 days ago
Baystate Health Springfield, United StatesLung Cancer Screening Program Clinical Nurse Coordinator:Clinical (nurse) Coordinator: Develops/facilitates systems approach to care delivery for a given patient population across care continuum. Assumes leadership role in planning and implementing clinical initiatives that impro ...
-
Pediatric Clinical Psychologist R24577
4 weeks ago
Baystate Health Springfield, United StatesReq#: R24577 · Category(s): Behavioral Health, Psychologist · Full Time / Part Time: Full-Time · Shift: First · Baystate Health is seeking a Full-time Pediatric Psychologist · What You Will Do: · This generalist position in the Child Behavioral Health department will primarily em ...
-
Clinical Risk Manager R29846
4 weeks ago
Baystate Health Springfield, United StatesReq#: R29846 · Category(s): Legal/Compliance/Risk, Risk · Full Time / Part Time: Full-Time · Shift: First · Baystate Health's Clinical Risk Managers are an integral member of the healthcare team. As the Risk Manager, you will be responsible for identifying potential losses to the ...
-
Clinical Risk Manager
2 weeks ago
Baystate Health Springfield, United StatesBaystate Healths **Clinical Risk Managers** are an integral member of the healthcare team. As the Risk Manager _,_ you will be responsible for identifying potential losses to the organization, both clinical and enterprise, developing and maintaining appropriate loss prevention po ...
-
Intake Clinician
1 week ago
Mental Health Association - Western MA Springfield, Massachusetts, United States PermanentMental Health Association is hiring immediately for an Intake Clinician. The Intake Clinician will work in a community behavioral health and addiction setting, providing services to individuals experiencing a mental health and/or substance use disorder need. The Intake Clinician ...
-
Director of Clinical Services
2 weeks ago
Pathlight Group Springfield, United StatesAre you a PBS Qualified Clinician or a Licensed Behavioral Health Professional looking to step into a leadership role? Our Full-Time Director of Clinical Services position in Springfield, MA might just be the perfect fit for you Imagine having the opportunity to lead a team of de ...
-
Dir Patient Care Services
4 weeks ago
Baystate Health Springfield, United StatesSummary: · This position leads the strategic development of identified services at an organizational level.The position is accountable for the administration and support of clinical and service programs in the assigned departments. The incumbent is responsible for the development ...
-
Clinical Research Coor II
2 weeks ago
Baystate Health Springfield, United States**Summary:****Job Responsibilities:****1)** Works under limited supervision. Supervisor available to handle most unusual situations and review progress of work**2)** Conducts study tasks which are moderately complex to complex in accordance with established protocols or guideline ...
-
Clinical Psychologist R28780
4 weeks ago
Baystate Health Springfield, United StatesReq#: R28780 · Category(s): Behavioral Health, Psychologist · Full Time / Part Time: Full-Time · Shift: First · Baystate Health is seeking a Full-time Child & Adolescent Psychologist · Up to $5,000 sign-on bonuses (external applicants eligible) · What You Will Do: · This generali ...
-
Chief Medical Executive
1 week ago
CS Trinity Mirror Springfield, MA, United StatesTrinity Health Of New England - the region's largest nonprofit health system - is seeking its next Chief of Primary Care within our Medical Group located in Springfield, Massachusetts. The Chief will be a Board Certified Internal Medicine or Family Medicine Physician with proven ...
-
Licensed Outpatient Clinician
1 week ago
Mental Health Association Springfield, United StatesThe Licensed Clinician will work in a community behavioral health setting, providing services to individuals, couples and/or families experiencing a mental health and/or substance use need. Services will include provision of comprehensive assessment, ongoing counseling for mental ...
-
Breast Oncology in Central Massachusetts
1 week ago
Enterprisemed Springfield, United StatesA healthcare system in central Massachusetts with the region's only academic cancer center program is actively seeking a Breast Oncologist to join its team of 12 Physicians and 5 Advanced Practice Providers. This is a fully integrated cancer center that includes radiation, gyneco ...
-
Clinical Research Coor I
4 days ago
Baystate Health Springfield, United States**Summary:**The Clinical Research Coordinator I will be the primary administrator of site, will monitor the research plan and protocol, ensure subject enrollment goals are being met and that analyses are occurring on time. He/she will also managing the components of the project, ...
Director of Clinical Integration - Springfield, United States - Baystate Health
Description
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:
At Baystate Health we know that treating one another with dignity and equity is what elevates respect for our patients and staff. It makes us not just an organization, but also a community where you belong. It is how we advance the care and enhance the lives of all people.
DIVERSE TEAMS. DIVERSE PATIENTS. DIVERSE LOCATIONS.
Education:
Master of Science (Required)
Certifications:
Registered Nurse - State of Massachusetts
Equal Employment Opportunity Employer
Baystate Health is an Equal Opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, marital status, national origin, ancestry, age, genetic information, disability, or protected veteran status.