POSITION SUMMARY:

The Senior Manager, BH Community Partners Program, is a key position in the Population Health Services Division at Boston Medical Center Health System. The Population Health Services Division serves as the central hub for programs that serve patients across the state of Massachusetts as part of our Medicaid ACO program.

The Manager will serve as our operational and clinical leader for the MassHealth (MH) Behavioral Health Community Partners (BH CP) program. Community Partners are community-based care organizations that partner with ACOs to provide care coordination / care management services to Medicaid members. Behavioral Health Community Partners focus primarily on members with BH needs. BMCHS has not historically participated as a BH CP, but in this new waiver is joining two existing BH CPs as an affiliated provider - Boston Healthcare for the Homeless and Lowell Community Health Center.

The BH CP Senior Manager will oversee all aspects of the BMCHS-run BH CP program: program design, relationship management with the partner BH CPs, hiring, oversight, and performance management for care coordinators, ACO relationships, integration with sites and other care management programs, analytics/measurement, and general operational oversight. The Senior Manager will have at least two clinical care managers reporting to them, who each supervise an additional 5-10 clinicians. The Senior Manager will partner closely with the overall BMCHS CP leadership within the Population Health team, the BMCHS Complex Care Management team, and other key clinical and administrative leaders working on the Medicaid ACO program.

Position: Senior Manager

Department: Behavioral Health Community Partners Program

Schedule: Full Time

ESSENTIAL RESPONSIBILITIES / DUTIES:

Specific duties and requirements:

• Program operations: Provide administrative and leadership support for BH CP operations. Work with the care coordinators and partner organizations to develop the infrastructure to support patients' referral needs and oversee the operation of care coordination, protocols, assessments, and supervision.
• Clinical oversight: Manage the team of care coordinators providing BH CP services. This includes overseeing outreach to Assigned Enrollees, initial assessment, and the care coordination and planning process. It also includes managing all aspects of state and federal requirements for licensure and care, including grants management, regulatory agencies, and hospital programs. In addition, responsibilities include oversight of Care Plan creation, documentation, Qualifying Events, and home visits. Finally, this includes developing and implementing strategies to ensure that gaps or challenges (e.g., follow-up) are addressed and improved.
• Design a coordinated BH CP strategy: ACO provider organizations, WellSense, and community organizations currently provide a broad range of care coordination programs. They represent a diverse set of programs - who they serve, where they operate, how they are paid, how success is measured. The Senior Manager will work closely with these program leaders and other BMCHS system leaders to define the role and goals of the BH CP programs in this broader care coordination landscape. They will develop a unified vision and program road map for the BH CP program that optimizes clinical outcomes, financial viability, and patient satisfaction, as well as meeting state and other regulatory body requirements.
• Partner management: Establish and manage relationships with the partner BH CPs (Boston Healthcare for the Homeless and Lowell Community Health Center), including payment terms, governance, performance management, and day-to-day communications.
• Data and Analytics: Partner with Clinical and Financial Analytics teams to define opportunities to optimize BH CP program performance
• IT program optimization: Partner with IT leadership to optimize IT supports and integration for BH CP partners.
• Local site engagement and communication: Partner directly with ACO site leads on local CP-Primary Care integration strategies, including clinical partnerships, communications, workflows, and reporting.

Req id: 27183