Manager, Social Determinants of Health
Steward Health Care Network (SHCN) takes pride in its community-based care model, which drives value-added tools and services to our communities, patients, physicians, and hospitals across the continuum of care. In addition, Steward Health Care Network promotes care coordination and collaboration within the network in order to provide high-quality, efficient care to patients. With Steward in the community, all residents can be sure that there is a world class doctor close to where they live.
The network is also responsible for the implementation and execution of our managed care contracts, medical management services, quality improvement programs, data analysis, and information services.
Under general direction of the Director of Behavioral Health, the Manager of Social Determinants of Health (SDOH) oversees, monitors, coordinates, and supervises the daily operations of Steward Health Care Network’s SDOH Care Management staff. The Manager of SDOH works collaboratively with the care management team and other internal and external stakeholders, including key practices, to maintain optimal processes and procedures to ensure an excellent level of service and clinical care. The Manager of SDOH is responsible for driving performance and managing the implementation of SHCN initiatives to support individuals with identified needs. In this position, the Manager of SDOH will manage, monitor and evaluate program performance on a continuous basis. The Manager of SDOH will operate in a highly matrixed environment, liaising across operational and business teams as well as external vendors.
- Responsible for the direct supervision of the SDOH Care Management team. Supervision responsibilities include but are not limited to: reviewing cases to provide clinical support and feedback, monitoring caseload assignments and enrollment targets, reviewing case duration, and providing individual feedback surrounding programmatic performance targets.
- Provides direction and support to staff to assure departmental effectiveness and efficiency.
- Implements key tactics to meet key performance indicators to drive performance at both program and individual CM levels.
- Analyzes all available data (e.g., utilization, quality, and claims data) to identify trends such as ALOS (Average Length of Stay), readmissions, and ER (Emergency Room) use; designs, implements, and modifies care management activities accordingly.
- Identifies and uses available data to monitor and evaluate care management’s impact, and to inform and improve staff and system performance.
- Reports on project implementation and results in formats appropriate to all key stakeholders, escalating high-risk issues as appropriate and necessary.
- Conducts regularly scheduled staff meetings with members of the SDOH Care Management team which focuses on staff training and development, review/revision of workflow/processes, and review of programmatic performance targets.
- Identifies on-going educational needs and opportunities for staff, based on the requirements of the position and specific needs of the individual. Implements targeted staff orientation and training programs.
- Coordinates assessment of appropriate utilization of services, ensuring intervention as needed. Analyzes data, identifies patterns and trends, and ensures information flow to appropriate staff.
- Develops plans for corrective action on both an individual and program level in areas identified for improvement.
- Ensures patient care management plans are developed, implemented, and evaluated in collaboration with attending physician.
- Works collaboratively as part of the Care Management team for programs that cross the organization such as the ECF, Post Discharge Outreach, Behavioral Health and Embedded Care Coordination.
- Responsible for interviewing, selecting, orienting and training employees; planning, assigning, and directing work; evaluating performance; rewarding and disciplining employees; reviewing personnel actions of subordinates and addressing complaints and resolving problems.
- Identifies staffing needs to support the organization. Develops staffing strategies to ensure appropriate coverage to meet daily and unexpected requirements. Responsible for implementation, monitoring, and adherence of time off policies and procedures.
- Identifies and ensures adherence to evidence-based practice and care management outcomes.
- Maintains and builds relationships with practices and hospitals to support members and embedded staff
- Uses risk-adjusted data to optimize patient management and assignments.
- Works collaboratively with the department leaders and the IT department to ensure the maintenance of care management databases and use of care management documentation systems. Proactive about identifying and advocating for system enhancements that may be required to deliver high quality care management services. Collaborates with IT teams to implement, test, and deploy system upgrades and enhancements.
- Assists with the development, management, and forecasting of department budget. Monitors expenses within approved budget. Maintains equipment and services agreements as needed.
- Demonstrates leadership that creates and fosters a culture of continuous improvement in the department.
- Performs all job functions in compliance with applicable federal, state, local, and company policies and procedures. Carries out supervisory responsibilities in accordance with the organization’s policies and applicable laws.
- Travel throughout the SHCN network for meetings with internal and external stakeholders
- Other duties as assigned.
Education / Experience / Other Requirements
- Bachelor’s Degree in Social Work, Psychology, Counseling, Rehabilitation, or another related field
- Master’s Degree in Social Work, Psychology, Counseling, Rehabilitation, or another related field, preferred.
Years of Experience:
- Required 5 years of experience in health care setting focusing on outpatient/inpatient utilization, case management and discharge planning
- Required 2 years of supervisory/management experience
- Proven success in leading complex, highly visible projects within a large healthcare provider organization setting
- Experience launching and running successful care redesign initiatives for underserved communities, preferably with experience in BH, SUD and SDOH programs
- Ability to demonstrate leadership skills within a team environment, take control of situations when appropriate and achieve results, and take initiative in representing issues and potential solutions to management.
- Experience and understanding of Project Management methodologies, life cycle, and, ability to manage and drive projects towards a successful outcome.
- Excellent critical-thinking, problem-solving, and analytical skills.
- Ability to lead and motivate others to execute a plan in a rapidly changing environment.
- Ability to work collaboratively with health care professionals at all levels to achieve established goals and improve quality outcomes.
- Strong current working knowledge of care management and utilization management as well as new models of care such as Patient Centered Medical Home (PCMH) and Accountable Care Organization (ACO).
- Familiarity with the compliance and regulatory standards governing health plans and patient care including NCQA, URAC, federal, state, and other regulatory requirements.
- Ability to act in solving problems while exhibiting judgment and a realistic understanding of issues; able to use reason, even when dealing with emotional topics.
- Ability to remain open-minded and change opinions based on information, perform a wide variety of tasks and change focus quickly as demands change, and manage transitions effectively from task to task.
- Must possess a strong belief in an organizational culture that encourages valuing and best service excellence practices demonstrated through personal behavior and work ethic.
- Ability to work in several databases and to comply with established documentation requirements
- Exceptional organizational skills; ability to multi-task and work independently and part of a team
- Demonstrate ability to prioritize, multitask, and work in a rapidly changing environment with multiple demands
- Experience with Project Management software tools (i.e. MS Project, MS Excel, Innotas, etc.)
Equal Opportunity Employer Minorities/Women/Veterans/Disabled