Lahey Health Director, Operations - Mass Health ACO in Beverly, Massachusetts
The Director of Operations (Director) is responsible for managing the overall implementation plan for the MassHealth ACO. This includes tracking, reporting and auditing requirements (e.g., expenditure summary reports, progress reports, etc.), overseeing record keeping, quality reporting, and auditing and inspection of records, as applicable. The Director will closely liaise with the Director of Quality and Performance Improvement and the Director of Data and Performance Analytics as well as members of the finance, contracting, and legal teams, as appropriate.
Reporting to the Executive Director, the Director will support efforts to increase provider enrollment in the ACO and will flag concerns with respect to provider performance or participation, as necessary. The Director may supervise professional staff, including but not limited to, project managers, analysts, and quality improvement professionals.
Essential Duties & Responsibilities (including but not limited to):
Manage day to day operations, policies, and procedures of the MassHealth ACO
Ensure deliverables due to MassHealth are executed and submitted in a timely manner
Work in collaboration with the Lahey Health contracting department to monitor payment arrangements with MassHealth managed care organizations
Support the operational relationship with the MassHealth managed care organizations, in collaboration with the Executive Director
With the Executive Director, report into the quality and funds flow committees within the ACO governing board
Collaborate with the Director of Data and Performance Analytics to communicate performance comparisons across provider practice sites, and identify areas for integrating value-add services
Collaborate with Director of Care Management, Director of Quality and Performance Improvement, and Director of Network Pharmacy Management to identify and escalate issues with care management or population health performance as appropriate
Plan, develop, and review materials for member and provider ACO education
Participate in the process of identification of performance improvement projects, including creating associated analytics and financial justification. Provide additional supportive analytics as necessary
Communicate effectively with cross-functional teams
Track and ensure expenses stay within 5 year DSRIP and LCPN budgets
Develop a reporting methodology for quality and financial information to physician members
Maintain global budget performance reporting for physicians and hospitals
Provides supervision and mentorship to project management and administrative support staff
With support of project manager, participate in establishing and implementing project communication plan including progress reporting mechanism to keep project sponsor, key stakeholders, senior management, and various committees up to date with the progress of ACO related projects
Design and maintain information systems capabilities to support efficient contract management, support individual patient care management, and to allow accumulation of data for population management (by physician practice and ACO wide)
Complete other duties as assigned
Maintain strict adherence to the Lahey Health Confidentiality policy.
Incorporate Lahey Health Standards of Behavior and Guiding Principles into daily activities
Comply with all Lahey Health Policies.
Comply with behavioral expectations of the department and Lahey Health.
Maintain courteous and effective interactions with colleagues and patients.
Demonstrate an understanding of the job description, performance expectations, and competency assessment.
Demonstrate a commitment toward meeting and exceeding the needs of our customers and consistently adheres to Customer Service standards.
Participate in departmental and/or interdepartmental quality improvement activities.
Participate in and successfully completes Mandatory Education.
Perform all other duties as needed or directed to meet the needs of the department.
Education: A Master's degree in Public Health and/or Business /Healthcare Administration.
Licensure, Certification & Registration: None
Experience: 7-10 years of related experience. HealthCare leadership preferred.
Experience with State agency payers.
Experience with health care providers.
Experience with measurement, reporting, and improvement activities.
Skills, Knowledge & Abilities:
Demonstrated leadership accomplishments in the overall improvement of financial, quality and operational performance of an organization.
Proven track record of formulating and executing strategies that have positioned the organization for success within an advanced managed care marketplace.
Experience with contracts with significant quality performance incentives.
Experience tracking budgets.
Substantive, working knowledge of healthcare finance.
Knowledge of the Massachusetts health care system, its nuances and market dynamics. Thorough understanding of current trends and best practices is required.
Excellent written, verbal, and interpersonal communications skills, including the ability to translate the language of healthcare finance into practical and useful daily operations information.
Excellent presentation skills and the ability to facilitate diverse group discussions that progress towards consensus.
Proactive and creative problem solving skills.
Strong project management skills. Able to balance competing priorities, complex situations, and tight deadlines.
Proven success managing a multiplicity of relationships and maintaining each with equal priority.
Conducts oneself with integrity and the highest ethical behavior and role models this behavior.
Strong computer skills.
About Lahey Health
The Lahey Model of Care - right care, right time, right place - is exactly what patients, providers and payers need and deserve. Identifying and delivering on this convergence of interests has positioned Lahey Health for further growth. Our model ensures care is highly coordinated and locally delivered, with lower costs and exceptional quality.
Lahey Health is a robust, regional system including a teaching hospital, community hospitals, primary care providers, specialists, behavioral and home health services, skilled nursing and rehabilitation facilities, and senior care resources throughout northeastern Massachusetts and southern New Hampshire. The system has a global presence with programs in Canada, Jordan and Bermuda.
How To Apply
Please apply directly online at http://www.laheyhealth.org/engage-with-us/careers. Use the Job ID number to quickly locate the appropriate job listing. Once you have located the desired job, click on the checkbox in the 'Select' column, and then click the 'Apply Now' button, located at the bottom of the screen. Please note you are only able to select 5 jobs at a time.
Lahey Colleagues please apply directly through Colleague Connection using your Login and Password.
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