Manager, Clinical Care Partnerships - Northern Worcester

Position Summary:

The Manager, Clinical Care Partnerships will play a vital role in the success of the entire Care Partnership organization at CCA. The main expectation of the Clinical Manager is to be accountable for the performance of the team, by ensuring that all key performance metrics are met as well as the team's daily operations, including the member experience, care management, care coordination, and care delivery. The Clinical Manager will ensure that the team meets clinical and health plan related KPI's (Key Performance Indicators) which are set by clinical leadership, regulators, and the business. Commonwealth Care Alliance's (CCA) Care Partner Team is primarily responsible for providing longitudinal care coordination, care management, and care delivery to a

dedicated panel of CCA members, a group of individuals with significant medical, behavioral, and social complexities.

As a keystone of the Clinical Group leadership team, the Manager, Clinical Care Partnerships participates in the development of tactics and is responsible for the execution of strategies to meet objectives. The Manager, CCP is engaged in the hiring and onboarding, performance management and staff enablement to support and improve care delivery, care management, and clinical operations in alignment with the strategic goals of CCA.

Supervision Exercised: Yes

Essential Duties & Responsibilities:

• Leads a team comprised of nurses, advanced practice clinicians, behavioral health clinicians and community health workers.
• Some team members may report to a discipline specific manager, with a matrix reporting to the Clinical Manager
• Holds team accountable to meet Key Performance Indicators, proactively identifies areas of opportunity and improvement for individual contributors, creates action/development plans for individual contributors and follows through on plans.
• Ensures that work is evenly distributed across the team, collaborates with other clinical managers to ensure even distribution across teams
• Accountable for quality and financial outcomes, service utilization, targeted case mix and productivity levels of Care Partners
• Collaborates closely with Behavioral Health leadership to ensure appropriate integration within the team
• Models collaboration with other CCA "specialties" including palliative care, women's health, diabetes management, and the medical directors.
• Active participant in Medical Management initiatives, working toward CCA's goal of impacting the cost of health care for the dual eligible population
• Is responsible for the Root Cause Analysis process within the team, reviewing all inpatient medical hospitalizations to identify areas of opportunity and improvement for individual contributors.
• Reviews service plans to ensure "right sizing" by identifying areas to impact financial outcomes.
• Depending on licensure level, may collaborate with Clinical Director on this process
• Participates in the selection, hiring, and onboarding of staff as well as performance appraisal.
• Addresses internal personnel issues, problem-solves local issues and engages in conflict management
• training.
• Provides clinical guidance and coaching for complex situations throughout the team.
• Acts as mentor and coach to new Clinical Managers
• Leads team meetings and selective (audit oriented) high risk case reviews)
• Lead re stratification discussion to ensure members are in the correct care model
• Provide oversight over new hire orientation in close collaboration with CCA's Education Department
• Prepares and analyzes reports to manage patient care and team performance
• Reviews clinical documentation and records to ensure accuracy and timeliness
• Provides input to Clinical Director and senior leadership into strategies to improve the performance of CCA
• Works cross-functionally within the organization to overcome barriers to effective and efficient local work flows
• Participates in cross-organizational working groups to continuously improve practice
• Develops, refines, and enhances clinical programs, initiatives, processes, policies, workflows, and projects.
• Participates in CCA Quality Improvement efforts.
• Participates in committees and workgroups that promote clinical excellence and help to advance CCA's mission and business objectives.
• Actively participates in the evaluation of own performance and progress.
• The Manager, Clinical Care Partnership directly manages an interprofessional team of Care Partners with matrixed reporting of advanced practice, behavioral health and HOW team members
• Provide clinical care to members via telehealth technologies (video, chat, etc.) for a clinically appropriate clinical care and care management services.
• Have a commitment to observing, reporting, and enhancing patient and employee safety as part of an overall emphasis on continuous improvement, learning, and member experience in the organization.

Working Conditions: Office environment with occasional field visits

Required Education:

• Associates Required or Diploma in Nursing

Desired Education:

• Bachelors Preferred.
• NP or PA strongly preferred 5 plus years

Required Licensing:

• RN, NP, PA with licensure in good standing in the state they are hired to work

Required Experience:

• 5 plus years of related clinical experience

Desired Experience:

• 2 plus years leadership experience preferred

Knowledge, Skills & Abilities:

• Experience with cross-functional collaboration for process improvement
• Strong management and team-building skills
• Ability to manage significant change
• Excellent communication skills
• --depth knowledge of CCA resources, clinical guidelines, systems, and processes
• Ability to teach, mentor, and coach across disciplines
• Ability to quickly shift gears and move in a new direction without clear guidance
• Willing to learn and utilize telehealth technologies (video, chat, etc.), when appropriate, for a variety of clinical care and care management services.

Language(s):

• Fluency in English required;
• Fluency in one or more of the following languages strongly preferred: Spanish, Portuguese, Russian, Nepalese, and Vietnamese is preferred.

Other:

• Physical requirements:
• The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job
• Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions
• While performing the duties of this job, the employee is regularly required to sit and stand; use hands to finger, handle, or feel; reach with hands and arms; and talk or hear
• The employee is occasionally required to walk, stoop, kneel, crouch, or crawl
• The employee must frequently lift and/or move up to 10 pounds and occasionally lift and/or move more than 100 pounds
• Specific vision abilities required by this job include close vision, distance vision, and ability to adjust focus
• Standard office equipment
• Experience with electronic medical record strongly preferred (eCW a plus)