The Director provides leadership and management for the daily ACO initiatives within MemorialCare Medical Foundation. This position executes the strategic and tactical priorities, operational, and financial business plan for the ACO and is responsible for developing and supporting a sound infrastructure and policies and procedures consistent with these objectives. The ACO Operations Director will be responsible for identifying opportunities for the ACO to improve patient health outcomes, increase revenue, reduce expenses, manage relationships and thus maximizing the bottom line. This position will develop an effective and efficient team of project managers and care coordinators to manage the ACO day to day operations. Relationship management within and external to the department with peers and executive leaders to facilitate effective workstreams and infrastructure support.
Principal Duties and Responsibilities:
Ensuring successful operations and building and maintaining ACO infrastructure.
Assessing and evaluating the ACO performance and infrastructure and works with ACO leadership to identify opportunities and implement improvements
Responsible for the daily operations of the ACO to ensure ACO goals and initiatives are met
Ensure ACO initiatives are aligned with MemorialCare Medical Foundation’s Bold Goals and contractual obligations in an effort to achieve the Triple Aim
Promote positive working relationships with providers, staff, managers, executive leadership, patients, and health plan partners
Daily operational oversight for the care coordinators and ACO project managers
Facilitate monthly ACO Steering committee meetings providing status reports for all ACOs
Participate on monthly and quarterly joint operations calls/meetings with Health Plan partners
Assist with the development and implementation of strategy and tactics to maximize the ACO’s value
Working in partnership with the data analyst and Executive Director track, trend, and analyze member, as well as population level data on an ongoing basis to evaluate the impact to overall ACO objectives and adjust processes as needed
Support a patient-centered model for care delivery
Matrix reporting relationship with the data analyst develop reports and analyses for regular presentation to executive management and others as required on health outcome measures, key indicators of operations, and related issues
Administer the daily operations of the ACO and develop all necessary ACO policies and procedures
Oversee ACO performance through hiring and retaining capable personnel, ensuring efficient processes are in place, maintaining appropriate staff and physician communication, implementation of appropriate workstream committees
Collaborate with network management, medical management, finance, compliance, clinical operations, and other internal departments to ensure all contractual ACO obligations are met
Oversee the development of best practices and tools for ACO project execution and management
Oversee the development of all ACO project management capabilities including project charters, project plans, implementation timelines, and communication plans
Coach, mentor, and motivate ACO project managers, care coordinators, analysts and influence them to take positive action and accountability for their assigned work
Responsible for staff selection, orientation, workflow development and evaluation to ensure timely and effective deliver of ACO requirement.
Coordinate with other departments (IT) to develop & ensure the appropriate tools, data & work methods are available at the point of service for ACO staff.
Develop positive working relationships with key internal & external constituents.
Develop a highly motivated workforce utilizing the MCMF Service Excellence Model
Demonstrated ability to deliver on time and complete work product support High Reliability Organizations (HRO)
Knowledge & Experience:
Minimum 3 years project management experience, preferably within the healthcare industry
5 years or greater of managerial/supervisory experience
Prior years ACO experience
Lean methodology experience preferred
Principles of Health Care Management
Understanding of Medical Group and IPA Operations
Understanding of Population Health
PMBOK Project Management methodology
Understanding demonstration of Triple Aim performance
Understanding of complex data management required for roster building & maintenance
Understand the current regulatory environment governing Alternate Payment Model work (APN)
Bachelor's degree Required (business, health administration, public health, or related field)