Director of HHC - Health Home Operations - New York City Health and Hospitals Corporation (New York,
The New York City Health and Hospitals Corporation (HHC), the largest municipal hospital and health care system in the country, is a $5.4 billion public benefit corporation that serves 1.3 million New Yorkers and nearly 400,000 who are uninsured. HHC provides medical, mental health and substance abuse services through its 11 acute care hospitals, four skilled nursing facilities, six large diagnostic and treatment centers and more than 80 community based clinics.
NYC HHC Health Home Program provides care coordination services to Medicaid patients with complex chronic medical and behavioral health conditions. These are patients who rely heavily on emergency services and tend to have high readmission rates. The program, which will work with providers across multiple care settings and collaboratively manage shared patients will aim to improve health and care outcomes and to reduce avoidable admissions and utilization of emergency care services.
Director of HHC HH Operations:Reports to Sr. AVP, Office for Ambulatory Care Transformation and is responsible for establishing and managing program operations and business systems, and contracts, reporting mechanisms, and policies and procedures required to operate the Health Home Program. Collaborates with Network partners and providers to implement HH operations across the HH Network in order to ensure sustainability and to meet the triple aim for HH Program (improve health, improve care and reduce cost of care). Specific responsibilities and accountabilities of the Director of Health Home Operations will include:
- Establishing operations and processes to support the required functions of HHC's HH Network.
- Establishes administrative processes to effectively connect and integrate HH Care coordination services with clinical and supportive services provided to HH patients within HHC and in the community.
- Responsible for managing the HH Program and program staff centrally.
- Establishes communication systems and processes.
- Implements Consent Management Policy and processes across HH Network. Will work with HHC IT to establish an auditable consent management for system Health Home patients.
- Implements workflow and dataflow generated by HH Work and IT Work Groups for HH patient roster and care alert messages. Works with appropriate clinical and operations management groups to develop and implement the policies and procedures required to guide response to care alerts for Health Home who present for care in such key service settings as EDs. Implements agreed upon response and response time standards and monitors care alert response across HH Network.
- Drives, manages and monitors HH outreach and enrollment performance across HH Network. Monitors enrollment rate results from all sources, assesses enrollment performance by method used (telephonic, face-to-face, etc.), site where activity is conducted, and by individual and agency who conducted enrollment. Uses O&E performance rates to manage and/or discontinue contracts with poorly performing contracted O&E service providers.
- Works with MetroPlus and HHC IT, Revenue Management and Billing Departments to establish appropriate and effective work flows for data collection and billing processes for FFS, MetroPlus and Non-MetroPlus HH members and develop the contracts, agreements and policies and procedures to ensure that the processes established to integrate the various inflowing and out flowing data streams are complete, aligned and reconciled
- Manages HH budget to ensure that funding for required contractual services and supporting staff and supporting operations is deployed and supports HH implementation.
- Establishes a communication process to ensure HH partners and providers of care are involved and engaged in and informed about performance data, policy, protocol and process changes, and updates to the HH Program.
- Responsible for communicating on a regular basis, HH Program implementation progress and performance and for identifying and defining specific issues that require program modifications or policy changes.
Qualifications: Position requires an individual with knowledge of complex care delivery systems, including managed care, finance, and IT operations, and the complex care coordination needs of special needs populations. An MBA, MPH or MPA, and 3-5 years demonstrated experience implementing and managing care delivery or care management programs in a complex care delivery system is required. Clinical background favored.
• Post ID: 36830547 newyork