Boston Medical Center Hiring for Senior Manager of ACO Operations Job at Boston, MA Full Time

The Senior Manager of ACO Operations oversees ACO programs at ACO sites across the Boston Accountable Care Organization (BACO) network. 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 Senior 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. Boston Medical Center (BMC) is more than a hospital. It’s a network of support and care that touches the lives of hundreds of thousands of people in need each year. It is the largest and busiest provider of trauma and emergency services in New England. Emphasizing community-based care, BMC is committed to providing consistently excellent and accessible health services to all-and is the largest safety-net hospital in New England. The hospital is also the primary teaching affiliate of the nationally ranked Boston University School of Medicine (BUSM) and a founding partner of Boston HealthNet – an integrated health care delivery systems that includes many community health centers. Join BMC today and help us achieve our Vision 2030 which is a long-term goal to make Boston the healthiest urban population in the world.

Position: Senior Manager of ACO Operations
Department: ACO and Population Health
Schedule: Full Time

The Senior Manager of ACO Operations oversees ACO programs at ACO sites across the Boston Accountable Care Organization (BACO) network.

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 Senior 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:

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  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 Senior 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.
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  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 Senior Manager of ACO Operations will directly oversee a staff deployed to local sites to address performance on the quality metrics. The Senior Manager will be responsible for defining a quality improvement strategy at each site, and ensuring successful implementation.
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  Risk coding optimization: Performance targets in the MassHealth ACO program are in part determined by the assigned risk level of the BACO population. The Senior 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.
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  Local site program communication: The Senior 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.

Education:

Bachelor’s Degree of Arts or Science or equivalent work experience.

Master’s Degree in Healthcare Administration, Business Administration, or related fields strongly preferred.

Experience

Requires a minimum of 6-8 years of experience in a healthcare business environment with at least 3 years management experience. Some experience in an outpatient clinical setting is required.
Req id: 18237