Senior Program Manager, Medicare ACO
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: Provides strategic, operational, and analytical support for Steward’s Medicare ACO Programs which include Bundled Payment for Care Improvement (BPCI), the Medicare Shared Savings Program (MSSP), and the Direct Contracting Program (DC).
- Prepares financial and risk analysis to support senior leadership and the project objectives
- Coordinates with internal and external analytics teams to prepare regional and national slides for monthly closes meetings
- Develops recommendations and implements processes for Profit & Loss monitoring and management
- Assists in vendor contract negotiation and management activities
- Monitors and tracks vendor compliance with contract requirements and institutes corrective actions as necessary to ensure compliance
- Assists in the development and implementation of ACO compliance and privacy program
- Ensures all required files and documentation is submitted to CMMI and CMS in a timely manner
- Works collaboratively to resolve complex issues related to the initiatives
- Creates, interprets, and disseminates information across multiple internal and external stakeholders
- Ability to manage concurrent projects with competing priorities and aggressive deadlines
- Designs models and performs ad hoc analysis for the purpose of understanding the historical and future performance of initiatives
- Monitors, interprets, and reports on changes in performance, market trends, health care delivery systems, and legislative initiatives that impact program efforts (e.g., CMS ACO regulations, Massachusetts Health Reform, etc.)
- Prepares analysis and documents to support advocacy efforts with CMS and CMMI
- Interfaces with departments across the organization (e.g. legal, information technology, etc.) as necessary to support both internal and external initiatives
- Provides support for the key Steward Health Care Network (SHCN) leadership meetings including: the SHCN, SACN, SICN, and SNCN Board Meetings
- In collaboration with the Senior Director, helps lead several monthly leadership meetings, including but not limited to: Medicare Business Unit performance meetings and SICN, SACO and SNCN Compliance Committee meetings
- Responsible for direct supervision of ACO Program specialist(s)
Education / Experience / Other Requirements
- BA/BS Required. Master’s degree preferred
Years of Experience:
- Two to five years working in a fast-paced environment. Health care experience preferred, but not required, for the right candidate
- Analytical skills to collect information from diverse sources and summarize the information and data in order to solve problems. Accuracy and attention to detail are required
- Strong interpersonal skills and ability to interact positively with a wide range of constituents
- 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, and timelines and outcome measurement
- Must be able to maintain confidentiality of information
- Ability to function effectively within an ever-changing environment and to meet deadlines and reprioritize as necessary
- 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
- Strong knowledge in Microsoft Office applications – Word, Excel, Project, PowerPoint, Access; proven ability to learn new information systems as necessary
- Understanding of the health care delivery setting
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.