Shs-Mgr-Population Health Care Management

Description:

Positions Location: East Lansing, MI

Job Description

General Purpose of Job: As part of a larger Population Health Service Organization (PHSO) strategy, the Manager of Care Management will play an integral role in the larger ambulatory care management programming for Sparrow Medical Group (SMG) and Sparrow Care Network (SCN) practices, acting as the subject matter expert (SME) for both their locally assigned clinics. In addition to the operational oversight of embedded Registered Nurse Care Facilitators (RNCFs), the Manager will act as the change management lead as the health system shifts from a Fee-For-Service model to Value-Based Care (VBC).

Common Duties and Responsibilities: This position will act as the frontline SME for primary care practices for ongoing support, oversight, and training; but will also be a conduit to the PHSO and SMG Leadership to convey expanded needs, operational concerns, productivity reports, strategic opportunities, and future planning ideas. They will be relied upon for their valuable clinical, financial, and strategic insight and will serve as the operational care management lead.

Essential Duties:

This job description is intended to cover the minimum essential duties assigned on a regular basis. Caregivers may be asked to perform additional duties as assigned by their leader. Leadership has the right to alter or modify the duties of the position.

• Works with the PHSO Leadership team to develop and implement short-term and long-term care management/care coordination programming geared towards specific patient populations, identifying those that may be at risk and need additional services/support.

• Acts as the clinical SME for care management across the SMG/SCN practices and provides implementation support when new programs or workflows are initiated; specifically walking caregivers through Epic updates.

• Assists in the development and tracking of annual goals within assigned areas of responsibility, which are congruent with, and support larger health system priorities.

• Leads day-to-day management of multiple program initiatives by establishing project plans and objectives to ensure team goals are met.

• Works closely with direct reports, including other members of Leadership, overseeing new initiatives and providing insight/support where needed.

• Problem solves and intervenes with physicians, nursing staff, and office managers to facilitate better patient care and resolve barriers to care management functions.

• Collaborates and coaches' staff regarding complex cases and area of opportunities.

• Leads and supports continuous quality improvement.

• Works collaboratively with PHSO Leadership, Revenue Cycle and Managed Care Contracting to communicate and understand payer requirements, to optimize payment coordination, and to develop processes and systems to promote timely reimbursement for services rendered.

• Interfaces with the Human Resources (HR) Department, including but not limited to HR Business Partner, Recruitment, Compensation, Employee Relations, and Employee Services.

• Collaborates and supports the design and development of standardized clinical pathways in partnership with local stakeholders, reviewing and validating compliance data with any new workflow.

• Oversees a monthly report of denials, working to update and educate staff on coding concerns, while also partnering with Rev Cycle on trends or a change in payer programming.

• Completes best practice research when new areas of focus are identified or questions from Leadership arise.

• Establishes local level goals and objectives with direct reports, providing regular feedback on operational metrics and program implementation, completing thorough and personalized annual reviews.

• Delivers comprehensive employee onboarding and professional development training.

• Provides effective/efficient solutions to complex system-wide problems.

• Creates/provides input into the departmental policies, procedures, objectives, and budget-related items.

• Acts as a representative/liaison for the PHSO across the health system and within the community

• Completes special projects or presentations as needed.

• Supports internal administrative meetings where needed, including local Provider Meetings, Advisory Committee Meetings, Office Manager Meetings, SMG Primary Care Practice (PCP) Leadership Meetings, and Care Management Redesign Workgroups.

• Facilitates the monthly Care Facilitator Meetings to make sure the content in balanced and reflects concerns from both Lansing and Community Hospital groups.

Job Requirements

General Requirements • Unrestricted RN License to practice in Michigan Work Experience • Minimum 5 years of experience working with/mentoring new Care Facilitators • Minimum of 2 years of project management experience or leadership of large-scale multi-facility projects, in which one or more of the following occurred: o Demonstrated high competency in the execution of multiple large projects o Demonstrated competency in strategic thinking and leadership, with strong abilities in relationship management o Gained experience in managing resources to meet goals across multiple projects o Gained experience in leading multidiscipline, high-performance work teams/groups o Demonstrated competency in developing efficient and effective solutions to diverse and complex business problems • Experience with the Epic Care Management Module in Healthy Planet or leading ambulatory care program - preferred Education • Registered Nurse (RN) with a Bachelor's in a health-related field • Master's Degree in clinical or health-related field - preferred Specialized Knowledge and Skills • Proficiency with MS Word, Excel, Project, and Power Point required. Other software includes Visio, Enterprise Project Server, SharePoint. • Comprehensive knowledge of the local community • Demonstrates the ability to develop and maintain strong working relationships with colleagues at different levels of the business, up through the most senior levels within the enterprise • Ability to establish and maintain a high level of credibility with the physicians, executive management and business stakeholders and clearly articulate complex messages • Demonstrates the ability to extract pertinent information and reach sound conclusions from a variety of data and strategic meeting • Ability to create an open environment where conflicts as to project methods and priorities can be aired and resolved in an objective manner • Excellent communication skills, with the ability to clearly communicate vision, mission, goals, themes, and key priorities that guide and focus the efforts of others • Able to coordinate and balance requirements between clinical outcomes and administrative activities • Strong collaboration and influence capabilities • Exceptional organizational ability and the ability to achieve goals in the face of multiple pressures • Demonstrates the ability to effectively present information to physicians and senior staff, and apply presentation skills at all levels of the organization • Possesses flexibility to lead in an ever-changing work environment; ability to work with minimal direction and oversight; ability to deal with ambiguity and uncertainty • Superior prioritization, organizational, and management skills • Ability to work independently; resourceful and proactive • Clear and confident communicator internally and with members/external partners • Excellent problem-solving skills, particularly ability to react appropriately "in the moment" • Unyielding attention to detail • Prior BCBS Care Management Training - preferred

University of Michigan Health-Sparrow is an Equal Opportunity/Affirmative Action employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or protected Veteran status.

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Location: Sparrow Hospital

Activation Date: Friday, May 31, 2024

Expiration Date: Saturday, September 27, 2025

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