Positions Location: East Lansing, MI
Job DescriptionGeneral Purpose of Job:
The Manager of Clinical Integration (CI) is responsible for the transformation of care delivery through the development and implementation of value-based care concepts. The objective of CI is to transform the delivery of healthcare services, emphasizing value and efficiency through increased connectivity, enhanced coordination of care, standardization of work, and implementation of best practices amongst Sparrow Care Network (SCN) physician offices.
The Manager of CI, in coordination with the Population Health Service Organization (PHSO) team, has primary responsibility for understanding and maintaining compliance with SCN payer-based programs and value-based agreements. In addition, the Manager will have oversight for all aspects of network engagement, including SCN's Primary Care Chapters, Patient-Centered Medical Home (PCMH) development, as well as development and coordination of CI communications across the network.
Key Responsibilities:
In working toward the advancement of the objectives of SCN, the Manager of CI will:
- Coordinate the continued development of SCN Chapters, for the purpose of improving the quality and the efficiency of care provided, as well as physician engagement with SCN.
- Facilitate and help lead the SCN Board and Advisory Committees, including the coordination, alignment and oversight of multiple initiatives.
- Assist in the evaluation of opportunities associated with participating in innovative programs and demonstrations, including payer-based programs, to further the transformation to value-based care.
- Lead the physician engagement efforts to develop SCN's network, including Chapter facilitation, PCMH, and specialty care physician engagement to improve the quality and efficiency of care across the care continuum.
- Implement CI principles and concepts across the organization to drive quality and improve efficiency to achieve total network transformation.
- Provide oversight to SCN financial performance, including annual financial planning and the creation of policies related to network operations and incentive distributions.
- Evaluate CI information technology (IT) solutions.
- Develop and coordinate CI communications to improve quality and efficiency; foster a group culture; and promote SCN strategic objectives.
- Meet regularly in the community with SCN physician practices to discuss the administrative details of SCN's CI program, including education on strategic objectives, as well as receive feedback on Clinical Integration efforts.
- Communicate clinical quality, cost, and utilization data to SCN leadership, governance and physicians.
- Develop and coordinate educational outreach to physicians regarding SCN strategic initiatives, including CI and other quality improvement programs.
- Manage the various components of SCN operations, including assigned Caregivers.
- Facilitate and support SCN strategic partnerships, including compliance with all payer/incentive agreement related activities.
- Actively participate in the ongoing corporate strategic planning process.
- Ensure compliance with incentive plan programs and contractual obligations.
- Represent Sparrow and SCN on key strategic partner or payer governance committees and/or workgroups.
- Provide administrative leadership to SCN.
Job Requirements| Work Experience | * At least five years work experience in physician network operations. * At least ten years work experience in the health care industry. * Experience in the management, leadership, and/or development of a managed care entity, such as a CIN or other organization that has managed risk and has significantly engaged in population health clinical programs and services. |
| Education | * Bachelor's degree, preference in accounting, business, finance, or related healthcare field. |
| Specialized Knowledge and Skills | * Excellent interpersonal, motivational, organizational, and communication skills. * Experience managing projects that successfully achieve budget and timeline goals. * Experience in budgeting, forecasting, and financial reporting. * Basic understanding of report writing and the analytical development process. * Experience in preparing and delivering written and oral reports. * Knowledge of: o Blue Cross Blue Shield of Michigan Physician Group Incentive Program o CMS Accountable Care Organization Program o Healthcare industry and operations, within medical groups, hospitals, and related settings across the continuum of care. o Chronic care delivery models, such as Wagner Chronic Care Model and the Patient-Centered Medical Home Care. o Value-based payment models, including an understanding of services impacted by managed care and health reform legislation. * Working knowledge of the development, implementation, and/or oversight of quality improvement efforts (i.e. knowledge and application of six sigma, Lean, total quality management, continuous quality improvement, and/or similar methodologies.) * Experience in the development, implementation, and/or oversight of provider incentive distribution models and financial incentive programs (e.g. pay-for-performance, gain sharing, shared savings, co-management). * Ability to facilitate difficult conversations with physicians and office leadership regarding performance concerns. * Demonstrated ability to plan, organize, prioritize, and manage multiple ongoing, concurrent projects. * Able to lead and work in collaboration with SCN Board Members and executive teams |
Sparrow Health System 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.
