The Director, Complex Care Management oversees the Complex Care Management program implementation and staff across the Boston Medical Center Health System’s (BMCHS) Accountable Care Organizations (ACO), 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 of Population Health Services, 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 BMCHS’s 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.

Key Functions/Responsibilities: 

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
• Develop partnerships with leaders across BMCHS, including Boston Medical Center Health Plan, Boston Medical Center, the Faculty Practice Foundation, and JV partners across Massachusetts

Metrics 

• Design 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

Position will perform other duties as assigned

Qualifications:

Education: 

• Master’s Degree in a health-related field

Experience: 

• 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

Competencies, Skills, and Attributes: 

• Ability to partner with a variety of clinical sites, including community health centers, community hospitals, and academic medical centers where care management programs are deployed.
• Excellent interpersonal skills and ability to work collaboratively across organizations and stakeholders
• Ability to attract and develop top talent at the Manager and front-line level
• Excellent written and verbal communication
• Clinical operational experience
• Advanced analytic abilities, including ability to define gaps and opportunities for improved performance and translate performance insights into operational actions
• Business planning skills; ability to write clear and effective business plans for new programs
• Ability to adapt to changes in healthcare delivery at local and systems level
• Strong organizational and time management skills

Required Skills Required Experience

+--------------------------------------------------------------------------+ | KNOWLEDGE, SKILLS, & ABILITIES | +--------------------------------------------------------------------------+ | - Excellent computer skills including Outlook, MS Word, Excel, | | Access, PowerPoint. | | - Ability to interact and communicate effectively with other Agency | | and departmental personnel. | | - Ability to learn and understand online software applications. | | - Ability to plan, develop and implement projects while promoting a | | teamwork environment. | | - Ability to multi-task. Ability to establish work priorities, | | allocate workloads and work under pressure. | | - Some college or professional education is a plus. | | - Available to occasionally work evenings or weekends for special | | events.  | | | |   | +--------------------------------------------------------------------------+