Program Manager, Accountable Care Operations

Location: Wakefield, MA
Job ID: 171314-1A
Date Posted: Oct 20, 2021
Category: Professional

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Job Description

Welcome To

Welcome to the Beth Israel Lahey Health Performance Network (BILHPN). BILHPN is a clinically integrated network of physicians, clinicians, and hospitals committed to providing high-quality, cost-effective care to the patients and communities they serve, while effectively managing medical expense. Leveraging best practices in population health management and data analytics, BILHPN improves care quality and patient health outcomes across Beth Israel Lahey Health through population health initiatives. BILHPN brings together the expertise of more than 4,500 providers across Eastern Massachusetts who share a common goal to achieve success in a value-based delivery system. 

About the Job

Reporting to the Director of Payor Program Operations the Program Manager, Accountable Care Operations supports the development and key operational tactics of the Federal and Commercial Accountable Care Organization programs of the Performance Network and supports compliance with state and federal reporting requirements. This position supports the Director of Payor Program Operations with designing and implementing processes to ensure compliance with CMS and State obligations and successful outcomes of program goals and metrics. Supports Payor Program Operations goals and manages the affiliate and network relationships required to achieve the Program's goals and meet internal, state and federal government requirements. Creates a culture of rapid cycle improvement, investigating and supporting implementation of program requirements, including applications, and supporting various workgroups needed to carry out program goals and obligations. 

The Program Manager's Responsibilities Are:

1. Under executive direction, plans and oversees multiple, inter-related, complex clinical and operational projects associated with the management of BILHPN Federal and Commercial accountable care agreements. Plans, manages and coordinates activities across BILHPN, insuring all projects and the overall program are tracking towards goals. (essential)

2. Supports the design, development, and implementation of a future Medicare ACO strategic plan for the new BILH Performance Network. (essential)

3. Facilitates administrative activities necessary to fulfill area objectives. Coordinates workgroups for thePayor Operations team and is the point of contact for vendors and other external organizations who serve as suppliers to support ACO programming. (essential)

4. Manages Medicare ACO operations, coordinating across and communicating with ACO leadership, steering and implementation teams, and workgroups to manage risk and ensure timely accomplishment of deliverables. (essential)

5. Facilitates and operationalizes relationships with external organizations including federal Medicare divisions (CMS and CMMI), community strategic partners such as other Medicare ACOs, NAACOS and State regulatory agencies as needed to support regulations for our risk arrangement operational oversight (essential)

6. Insures compliance with CMS/CMMI ACO goals and regulations across BILHPN; facilitates CMS/CMMI monitoring and evaluation activities. (essential)

7. Where necessary, provides project management or appropriate oversight of regulatory requirements related to the BILH Performance Network compliance with risk-bearing organization State regulation requirements as well as Determination of Need tracking and reporting requirements as required of the BILH PN (essential)

8. Serves as a subject matter expert on local and national managed care issues trends related to care transformation innovative payment models. Identifies contract and program opportunities, regulatory changes, industry practice changes that can potentially impact revenues, and communicates accordingly. (essential)

9. Supports management in the development and management of initiatives. Provides information for needs assessment, operational analyses and systems and/or process development. Analyzes and summarizes data used for decision-making purposes. 

Qualifications:

  • Bachelor's degree required. Master's degree in MBA, MPH or MHA preferred.
  • 3-5 years related work experience required.
  • Advanced skills with Microsoft applications which may include Outlook, Word, Excel, PowerPoint or Access and other web- based applications. May produce complex documents, perform analysis and maintain databases.

About Us

Beth Israel Lahey Health is dedicated to improving health and wellness and making a difference in the lives of our patients, their families and all members of the communities we serve.  Formed in March 2019, Beth Israel Lahey Health is a patient-centered, integrated care delivery system providing a continuum of services spanning academic, tertiary and community hospitals, dedicated orthopedic and psychiatric hospitals, primary and specialty care, community acute care, ambulatory care, behavioral services and home health.  Beth Israel Lahey Health Performance Network is a unified joint contracting and population health management organization, jointly governed by participating physicians and hospitals.

Equal Opportunity Employer/Minorities/Females/Disabled/Veterans.