BACO is comprised of 18 clinical sites, including a mix of academic medical centers (Boston Medical Center), community hospitals, (Holyoke, Sturdy, and South Shore) and community health centers across Greater Boston, Western Mass, and Southern Mass. Together with Boston Medical Center Health System (BMCHS), BACO is sharing risk for Medicaid patients as part of the new MassHealth initiative to transform healthcare via formation of Medicaid ACOs. In order to succeed in the Medicaid ACO, BMCHS is rapidly designing and implementing a number of programs to manage utilization and total cost of care. The Manager of ACO Operations will report to the Director of ACO Operations and will be responsible for overseeing operations at a subset of BACO sites. Specific oversight may include, but is not limited to, oversight of the following efforts:
- Complex care management operations: BMCHS will deploy Complex Care Management teams across the BACO network. Teams will be comprised of Nurses, Pharmacists, and Community Wellness Advocates, and they will manage the top 2-3% of high risk patients at each site. The Manager of ACO Operations will partner with BMCHS and local site clinical leaders to manage the Complex Care Management program, which may include: ensuring smooth integration with local site care management programs, analyzing cost and outcomes data to identify opportunities for program improvement, connecting with local community partners, and ensuring optimal program operations.
- Quality improvement efforts: The MassHealth ACO program includes a full set of quality metrics. The set of quality metrics encompasses a broad range of focus areas including adult primary care, pediatrics, behavioral health, and other outcomes-based measures. The Manager of ACO Operations will directly oversee a staff deployed to local sites to address performance on the quality metrics. The Manager will be responsible for defining a quality improvement strategy at each site, and ensuring successful implementation.
- Risk coding optimization: Performance targets in the MassHealth ACO program are in part determined by the assigned risk level of the BACO population. The ACO Operations Manager will be responsible for designing and implementing programs that ensure BACO providers are assigning the appropriate risk codes for their patient panels, including coding for social determinants of health, e.g. homelessness.
- Local site program communication: The Manager will be the key liaison between BMCHS and their assigned BACO sites. He/she will be responsible for communicating key information as well as troubleshooting a variety of program related issues, and facilitating their resolution.
The Managers of ACO Operations will be deployed across the BACO network and will cover a diverse set of PC sites. As such, it is essential that the Manager possess strong communication skills to ensure open lines of communication between local site leadership, central BMCHS leadership, and direct reports that may be geographically dispersed. Success in this role requires Managers to partner closely with local site leadership to implement change initiatives in outpatient practices. As such, successful candidates will have a demonstrated track record of leading improvement efforts in outpatient clinic settings, forming effective partnerships with clinical and operations leaders, and executing on complex operations projects.
Specific Duties may include:
- Works with the practices and the local management team to develop and implement long and short range business plans for practices. Meets regularly with the appropriate clinical leaders in each practice and at BMCHS.
- Analyzes data and information, develops strategies to improve operations and enhance service delivery; implements changes in conjunction with and advise from the management team. Acts as the liaison with relevant stakeholders to resolve problems that interfere with the efficient operation of ACO programs.
- Develops program performance standards in conjunction with the BMCHS and lcoal site management teams. Monitors program performance regularly against those standards and prepares and implements steps to bring the local program into conformance with those standards. Develops and implements cost-effective operational adjustments as appropriate to enhance program efficiency.
- Serves as liaison between BMCHS central management team and local site leadership. Facilitates communication and information sharing, serves as first point of contact for troubleshooting local site issues.
- Hires, develops, and manages selected ACO staff, within the prescribed policies of BMCHS. Interprets and enforces policies for all employees; establishes standards for performance for ACO staff and ACO programs.
- Under the direction of the Director of ACO Operations, assume a leadership role in executing new programs, including, for example: care management workflows and processes, building connections with Community Partners, and defining a quality improvement agenda.
- 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
- Performs other duties as needed
Bachelor's Degree of Arts or Science or equivalent work experience.
Master's Degree in Healthcare Administration, Business Administration, or related fields strongly preferred.
Requires a minimum of 5-7 years of experience in a healthcare business environment with at least 3 years management experience. Some experience in an outpatient clinical setting is required.