Senior Director, Complex Care

POSITION SUMMARY:

The Senior Director Complex Care Management oversees the Complex Care Management program strategy, implementation and staff across the Boston Medical Center Health System's (BMCHS) Medicaid Accountable Care Organizations (ACO), which are partnerships between the WellSense health plan and eight provider systems across Massachusetts including the Greater Boston, Southeast MA, South Shore, North Shore, Lowell, and Springfield/Holyoke areas. The Complex Care Management program includes direct delivery of field-based care management across the ACOs’ hospitals, primary care clinics, and community health centers, as well as partnership and management of delegated care management arrangements within the network.  

In close partnership with other leaders within Population Health Services, the Sr. Director will be responsible for setting a strategic vision for Complex Care Management as a key part of the larger BMCHS care management continuum, and overseeing operations and outcomes of the program. He/she will develop and maintain oversight 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 Sr. Director will continue to innovate and build programs and collaborations that enhance BMCHS's complex care management programs by leading efforts to develop targeted initiatives 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 Sr. Director serves as the primary subject matter expert and technical liaison for health system partners and leaders related to the development and delivery of care management programs. The Sr. Director is also a key representative to EOHHS and governmental leaders in advocacy of care management.

Position: Senior Director, Complex Care       

Department: Pop-Health Care Management

Schedule: Full Time

ESSENTIAL RESPONSIBILITIES / DUTIES: 

The Sr. 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 system leaders to support ACO retention and optimize integration of care management teams into Population Health strategy. 

Leadership within BMCHS: 

• In partnership with health plan and hospital leaders, iterate the strategy of the Complex Care Management program to support system goal and population needs, and to ensure ongoing close coordination between care management programs 

• Develop and nurture constructive partnerships with leaders across BMCHS, including Wellsense Health Plan, Boston Medical Center, the Faculty Practice Foundation, and leaders of joint venture ACO partners across Massachusetts; collaborate with provider leaders to iterate program adaptation to local practice and ACO needs as appropriate 

• Represent BMCHS in care management related discussions with state and representative bodies 

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 meeting state regulations and quality standards, while understanding the nuances of local clinical site dynamics and partnering 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 

• Contribute to the field of Complex Care through participation, leadership and advocacy in national forums and