Massachusetts Jobs

Title: Manager, Care Management Reports to: Director, Clinical Operations Classification: Manager Job description revision number and date: V.3; 9/3/24 Organization Summary: Community Care Cooperative (C3) is a 501(c)(3) non-profit, Accountable Care Organization (ACO) governed by Federally Quality Health Centers (FQHCs). Our mission is to leverage the collective strengths of FQHCs to improve the health and wellness of the people we serve. We are a fast-growing organization founded in 2016 with nine health centers and now serving hundreds of thousands of beneficiaries who receive primary care at health centers and independent practices across Massachusetts. We are an innovative organization developing new partnerships and programs to improve the health of members and communities, and to strengthen our health center partners. Job Summary: The Manager of Care Management is responsible for daily management of the C3 Care Management Program which includes enhanced care coordination activities of both MassHealth (Pediatric and Adult) and Medicare (Adult) Member Populations. This includes day-to-day mentoring and oversight of an interdisciplinary Care Management team comprised of RN care managers, Behavioral Health care managers, and Community Health Workers. In addition, the Manager provides performance oversight to FQHC/APP (Affiliated Participating Provider) Care Management Teams to ensure Care Management services are delivered in a high-quality, cost-effective manner. The manager is required to have a proficient understanding of MassHealth and CMS requirements to ensure care management workflows are implemented, in compliance with both federal and state regulations. The manager works closely with the Director of Clinical Operations and is responsible for performance and operational management of FQHCs/APPs participating in care management. Though this role is primarily Hybrid, it does require occasional office-based work in addition to in-person FQHC/APP-facing meetings. Responsibilities: Assess and monitor team performance using program metrics, data, and management reports to assess caseloads, engagement rates, outcomes, and other process measures Using data and managerial tactics, the manager will monitor staff performance including opportunities to improve and maintain performance standards In collaboration with the Director of Clinical Operations, the manager will develop, monitor, and report performance improvement needs of staff and FQHC/APPs Perform chart audits, provide staff, and group supervision, and complete performance reviews, including mid-year and annual goal setting Address operational needs including vacancies, participate in the hiring of staff, manage the onboarding, orientation, and training process, as well as manage Personal Time Off (PTO) coverage Ensure staff are informed, of policies and procedures and care management/program workflows Support the development of training content, including workflow updates that reflect most current MassHealth / CMS requirements, and participate in delivering training Build effective relationships with all external stakeholders including our primary customer, FQHCs and APPs Be first point of contact for urgent needs, such as staff managing complex patient issues, member complaint and grievance issues pertaining to care management and escalate to Director/leadership as appropriate Prepare CM performance material (PowerPoint) unique to each FQHC/APP or as an aggregate for meetings such as monthly clinical forums Attend monthly FQHC/APP clinical performance meetings and quarterly ACO meetings, present care management program performance data, as well as make recommendations on areas of improvement Be well-versed in understanding technology tools that support the care management program, including the care management platform and Health Related Social Needs (HRSNs) screening tool Ensure special initiatives such as HRS s, Flex benefits,