Dir ACO Operations
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POST DATE 8/12/2016
END DATE 10/19/2016
Hutzel / KEI Building
JOB DESCRIPTIONJob Title
Dir ACO Operations
Job Location Name
Hutzel / KEI Building
Reporting to the Vice President, Accountable Care Strategies, directs the personnel, financial and operational activities of the Accountable Care Department. Provides administrative and medical management support for the platform of programs and initiatives undertaken by DMC to improve health care value and transform care delivery such as the Michigan Pioneer ACO (MIPACO). Under the direction of the Accountable Care Department Vice President and DMC's Chief of Strategy Officer, provides leadership in the development and operations of the Michigan Pioneer ACO (MPACO) and other population health and risk sharing initiatives and programs for the DMC. More specifically, responsibilities of the Director could include the following with respect to any of the portfolio of programs administered by the Department:
- Assist in the design, creation and implementation of short and long term strategy and development plans.
- Assist in the development of additional population-based contracts for the DMC, seeking to enhance physician alignment through designing programs and initiatives unique to DMC that improve health care value and transform care delivery.
- Assist in the development, implementation and management of any population based contract incentive program.
- Analyze historical claims to find drivers for cost reduction and work closely with the executive team in adjusting physician protocols.
- Assist in the direction of the program's overall development efforts to reduce the annual cost of the patient population and maximize net shared savings.
- Understand how each population based contract is structured and ensure that the operating departments are structured and engaged to achieve maximum quality, satisfaction and economic results.
- Participate in the budgeting process and manage all assigned departments to meet or exceed targets.
- Oversee and manage the daily operational aspects of each program.
- Oversees, manages and evaluates the physician quality outcomes and work with Department Medical Directors to deploy tactical initiatives to meet or exceed goals.
- Manage key vendor contractual relationships, as assigned.
- Serve as a contact and liaison between Department and CMS, the State, and payors, as requested or assigned.
- Oversees compliance with the governmental regulations, requirements, and rules and regulations stated under any contract, law, regulation or rule.
- Oversees and manages program physician and beneficiary communication strategies and marketing materials.
- Ensures the development of the department procedure/protocols/processes and secures approval, as necessary.
- As directed, implements external and internal audit recommendations.
Data Analytic Support
- Assist in the development of tools to connect program physicians and care managers with real-time access to patient hospital admission, observation, ED and discharge alerts.
- Support processing, security, design and implementation of medical management, administrative and financial data and reports derived from CMS, State, or other payor or EMR files.
- Produce routine reports, physician dashboards, score cards and other tools that may be used to determine and report on any incentive bonuses.
- Direct the development and production of reports responsive to requests from Care Management staff that are required to manage the utilization of resources by program enrollees or beneficiaries.
- Lead and manage staff during the Center for Medicare and Medicaid Services (CMS) required Group Practice Reporting Option (GPRO) period, and any similar quality reporting required by the State, or other payor.
- Responsible for the follow-up submission of quality measures during the mandatory CMS quality audit and other similar audit by the State or other payor.
- Manages deployment of any quality measure assessment tools.
- Assist program in assuring that physicians have installed and are using a modular or full electronic health record system by end of each performance year and have attested for Meaningful Use dollars.
- Oversees the project management of quality reports and data extraction, including management of the relationship of data computation and file sharing between various IT providers, DMC, and physicians.
- Oversees the recruitment of participating physicians for each program during each program open enrollment period.
- Responds in a timely fashion to physician inquires and questions and maintains physician relations.
- Responsible for organizing physician events including town halls meetings and CME credit sessions.
Identifies the need for policy development and/or revision, defines policies in collaboration with higher level management input, goals and objectives. Oversees the development, implementation and/or revision of procedures/protocols in accordance with system-wide goals and objectives. Approves procedures/protocols and/or seeks other departmental approvals as appropriate. Develops, monitors and revises functional processes in accordance with goals and objectives. Provides input into the development and revision of organizational structure for area. Approves personnel actions such as hires, fires, disciplines, etc. Ensures the timely completion of performance appraisals. Develops current to intermediate goals and measures for area. Measures and assesses performance. As requested, assists in long-range goal development. Develops and monitors budget for area. Monitors activities for and ensures compliance with laws, government regulations, Joint Commission requirements and DMC policies. As directed, implements external and internal audit recommendations. Ensures hospital departments achieve objectives for diversity of their suppliers.
1. Bachelor s degree in Health Care Administration, Business Administration or related field, or the equivalent combination of related education and/or experience. Master s Degree preferred.
2. Five years of progressively more responsible experience in ACO, Health Plan, clinical integration, health care risk management, and/or hospital operations.
3. Project management experience preferred.
Directors / Managers / Supervisors
Monday - Friday
At Detroit Medical Center (DMC), we are committed to maintaining an environment of Equal Opportunity and Affirmative Action. If you need a reasonable accommodation to access the information provided on this web site, please contact the DMC facility where the position is available, for further assistance. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, age, protected veteran status or status as an individual disability.