Program Manager, Bundled Payments & Operations
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.
Position Purpose: Under the direction of the National Director of Bundled Payments, the Program Manager for Bundled Payments manages and leads all aspects of strategic and operational bundle initiatives. The Bundled Payments Program Manager will manage and support Steward's Bundled Payment for Care Improvement Advanced (BPCIA) risk contract with NaviHealth and the Centers for Medicare and Medicaid Services (CMS) and the Comprehensive Joint Replacement (CJR) program for all eligible Steward-owned hospitals. S/he will:
- Project manage ongoing and new operational initiatives that serve our communities and population
- Drive performance of initiatives through execution of high-value initiatives derived from data-driven recommendations.
- Monitor and ensure compliance with all applicable CMS regulations.
- Become a reliable policy and program subject matter expert on evolving CMS programs.
To this end, the Program Manager is responsible for a variety of tasks including, but not limited to, engaging with NaviHealth and Steward case management staff to develop and execute implementation plans, create, and coordinate resources to implement initiatives, and monitor and report on progress towards key program/business objectives.
- Demonstrates leadership by planning and overseeing multiple, inter-related, complex, operational, and clinical projects to drive performance improvements in care for Steward's BPCI-A and CJR population
- Manages and coordinates activities across SHCN operational teams, hospital workgroups, and program stakeholders to mitigate risks and ensure the programs are successful in achieving established goals
- Leads overall care redesign efforts to improve the care of our patients in collaboration with clinical subject matter experts and key stakeholders including NaviHealth, hospital teams and physicians
- Reviews physician and hospital scorecards on monthly basis to influence and modify behavior impacting program performance
- Facilitates and participates in Steering Committee meetings, CMS webinars, physician data reviews, and program education sessions with Board of Directors, hospital staff, vendor staff, physicians, and post-acute partners
- Assists with developing program budgets for annual planning cycles
- Ensures program-related submissions are submitted on time and error free
- Performs special projects as requested
Analysis and modeling:
- Identifies program risks, and develops and implements appropriate corresponding mitigation strategies, together with the Bundled Payment leadership team, vendor, and hospital leadership team
- Uses performance data versus expectations (financial, clinical, or operational) to prioritize opportunities and effectively drive operations
- Presents recommendations to targeted set of stakeholders including vendors, clinicians, and business leaders
- Identifies key performance metrics, develops systems to track key metrics, and monitors and evaluates progress and results of strategic initiatives
- Models and performs ad hoc analyses for the purpose of understanding the historical and future performance of program initiatives
- Creates, interprets, and disseminates information across multiple internal and external stakeholders
- Monitors, interprets, and reports on changes in performance, market trends, and federal regulations which impact program performance and processes (e.g., Medicare IP Only List and CJR Three-Year Extension)
- Proactively assists in the development and monitoring of program compliance workflows and processes
- Develop policies and procedures geared towards ensuring program compliance
- Facilitates and operationalizes relationships with external organizations including federal Medicare divisions (CMS and CMMI), NaviHealth and community strategic partners
Education / Experience / Other Requirements
- Bachelor’s degree in healthcare management, healthcare, business, or other health related field (or equivalent combination of education and experience)
Years of Experience:
- 3-5 years working in a fast-paced environment. Healthcare experience required; Medicare BPCI-A or CJR experience strongly preferred
- Strong interpersonal skills and ability to interact positively with a wide range of constituents
- Ability to work both independently and within a team environment and a multi-dimensional environment. Creative, flexible, self-motivated, professional must possess sound judgment ability to plan and initiate new activities consistent with achieving service excellence
- Proven excellent written and verbal communication skills. Ability to present information to small and, at times, large audiences
- Strong organizational and project management skills including development of project parameters, goals, timelines, and outcome measurement
- Established passion for working towards improving the health of populations
- Strong analytical skills used to translate complex data from diverse sources into useable information to solve problems
- Proficiency in Excel, Word, and PowerPoint; proven ability to learn new information systems as necessary
- Ability to function effectively within an ever-changing environment and to meet deadlines and reprioritize as necessary
- Must be able to maintain confidentiality of information
Steward Health Care is an Equal Employment Opportunity (EEO) employer. Steward Health Care does not discriminate on the grounds of race, color, religion, sex, national origin, age, disability, veteran status, sexual orientation, gender identity and/or expression or any other non-job-related characteristic.
Steward Health Care Network is taking additional, necessary preparations to ensure patients can receive compassionate care in a safe, carefully managed environment – with confidence and without fear.
Our Safe and Ready program consists of a rigorous [three-point] standard ensuring patient safety, confidence and convenience:
- Any COVID-19 related care takes place in designated areas away from other patients and their families.
- A stringent cleaning policy has been implemented throughout our facilities.
- A strictly controlled visitor and masking policy is required for patient and colleague safety.
You can rest assured that we have made the necessary preparations to provide care in a safe, controlled and professional way.