Manager-Practice Transformation; Remote, North Carolina

Overview

Manager-Practice Transformation (Full-time Remote, North Carolina Based)

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Home Office – Morrisville, NC 27560, USA (Remote options available)

The Manager of Practice Transformation provides oversight and direction to the Practice Transformation Specialists (PTS). Oversee the PTS work with Advanced Medical Homes (AMH+) and Care Management Agencies (CMA). Help develop the strategy for the PTS team in order for the AMH+ and CMAs to meet members needs and fulfill their CM credentialing criteria. Will work closely with the Sr Director of Payer and Practice Transformation to define the vision of the department based on data patterns and trends, Medicaid requirements and member needs.

The Manager of Practice Transformation is responsible for ensuring that the Practice Transformation team is performing effectively and efficiently in compliance with all applicable policies and contractual requirements, which include but are not limited to, auditing of work tasks, resolving provider issues, reviewing reports and developing work processes.

This position is full-time remote. Selected candidate must reside in North Carolina. Some travel for onsite meetings to the Home office may be required.

• Manage and develop staff to ensure the unit is effective
• Define and deliver the direction of the team(s) to align with organizational and personal goals
• Prioritize work and responsibilities to align with business initiatives; develop employee plans to improve core competencies
• Establish and implement a safe working environment meeting licensure, regulatory, and accreditation requirements
• Monitor staff productivity and interactions with providers, CIN, and internal Alliance staff
• Ensure staff are trained in Alliance and Practice Transformation policies, procedures, and processes
• Provide the department with tools to fulfill functions and support continuous quality improvement, interventions, value-based care, and data-informed care management
• Coach staff on new technology tools and change management to support learning and skill advancement
• Monitor PTS interactions with providers and CINs and frequency of interactions
• Manage PTS workloads and provide daily direction to meet team goals
• Assess quality measures and coach PTS to monitor provider CQI and data-informed care management

• Provide Training and Coaching to Network Providers
• Listen effectively to identify solutions for continuous quality improvement and data-informed care management
• Create and deliver presentations on various topics
• Educate on available resources and systems
• Assist PTS in resolving provider issues through 1:1 supervision and attending provider and CIN calls

• Understand Data
• Review data for providers and internal PTS; interpret data to inform workflows, panels, and workload assignments
• Lead PTS in understanding VBC goals and track provider trends with analysis

• Support Implementation of Provider Led Care Management and ongoing operations and growth of the program
• Implement with fidelity to care model and share challenges and barriers openly
• Work with providers and CINs to focus on data-informed care management
• Guide PTS, clinic staff, and leadership on best practices for data-informed care management
• Address barriers to CQI and the shift to data-informed care management
• Propose solutions for practices to address barriers
• Assist providers in panel management and understanding panel assignments
• Assist providers with understanding barriers related to Value Based Contracting agreements

• Collaborate with Internal and External Stakeholders
• Develop strong working relationships with providers, CINs, and external stakeholders
• Participate in local, regional, and state meetings as required
• Exercise conflict resolution skills to resolve issues with providers and external stakeholders
• Foster collaboration within Provider Networks and internal Care Management to achieve program and organizational deliverables

Master’s degree from an accredited college or university in Social Work, Counseling, Healthcare Administration, Public Health, Business Administration, and three (3) years of post-degree experience in…