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The Director, Complex Care Management oversees the Complex Care Management program implementation and staff across the Health System and Accountable Care Organizations, which includes hospitals, primary care clinics, and community health centers across Massachusetts including the Greater Boston, Southeast MA, South Shore and Springfield/Holyoke areas.
In close partnership with the Medical Director, the Director will be responsible for setting a strategic vision for Complex Care Management and overseeing day-to-day operations of the program. He/she will maintain close monitoring of outcomes and performance data, be responsible for adjusting program design and implementation to achieve program goals, and be accountable for helping to drive quality outcomes. Additionally, the Director will continue to innovate and build programs and collaborations that enhance complex care management programs by leading efforts to develop targeted programs that impact the highest cost patients, such as a homelessness programs, clinical specialty programs (i.e. End Stage Renal Disease, Sickle-Cell Disease, palliative care), and other community collaborations that strengthen connections across the continuum of care.
The Director will have the key responsibility for recruitment and retention of high-performing care management teams and will play a mission critical leadership role in interfacing with clinical sites to optimize integration of care management teams into existing clinical operations.
Care Management Program Management
- Define key program elements for care management programs, including: patient selection criteria, care management workflows and processes, team role composition, staffing ratios, etc.
- Centrally manage and implement a standardized care management program, but also understand the nuances of local clinical site dynamics and partner with local site leaders and existing local site programs to ensure program success
- Define methods for measuring program success and demonstrating program effectiveness in managing total cost of care; partner with Clinical Analytics leads to define data and reports needed to manage performance
Care Management Team Leadership
- Directly supervises management staff and indirectly oversees the management of up to 50 staff
- Hire, develop, and motivate Care Management Managers
- Define recruitment and retention strategy to attract top care management talent across Massachusetts
- Serve as key point person interfacing with local site leaders to ensure integration of care management teams into primary care practices and hospitals; design integration and onboarding plans for local CM teams, maintain open lines of communication with local site leaders
programs and interventions targeted at key program outcomes, including
- Reduction in ED and avoidable inpatient visits
- Decreased total medical expense
- Improved patient satisfaction
- Improved clinical outcomes
- Improved provider satisfaction
- Master’s Degree in a health-related field
- Extensive experience in clinical operations in a hospital, health system, provider practice, and/or community health center environment required
- Experience building and leading complex care management programs
- Experience building and managing a large team
- A minimum of 10 years of management experience preferred