![]() Strong proven leadership and experience with the MassHealth program (i.e., FFS, PCC, MMCO, etc.) network development and ACO experience is highly valued Maintains information in a confidential manner according to policy Requisite poise, judgment, and trustworthiness to represent Steward to internal and external groups (e.g., periodic early morning or evening meetings) Possesses excellent time management skills with proven ability to effectively manage multiple tasks and priorities at one timeĭemonstrates knowledge of managed care concepts for various health plan and capitated programsĬollaborates with multiple providers to provide quality and cost-effective care for risk members.Īccepts flexibility in work schedule willingly. Proven excellent written and verbal communication skills.Ībility to present information to small and, at times, large audiences Possesses strong background in health plan business, program, and operational functionsĬreative, flexible, self-motivated, professional able to navigate complex, matrixed environments Minimum of 5 years of experience in related roles, including large program implementations Master’s degree in health care related field strongly preferred Identifies opportunities in other Steward markets for potential participation in additional Medicaid ACO programsĮducation / Experience / Other Requirements 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)Ĭoordinates advocacy and lobbying efforts to drive Medicaid ACO program changes ![]() Identifies key tactical and operational initiatives and ensures such initiatives are professionally project managed to meet performance objectivesĭesigns models and performs ad hoc analysis for the purpose of understanding the historical and future performance of initiatives Identifies opportunities to continually innovate with Medicaid ACO population to achieve performance outcomes, including: ![]() Review and approve all regulatory-facing deliverables prior to executive sign-off and submission Manage relationships with state regulators, including the Executive Office of Health and Human Services and the Division of Insurance. Provide direction to the Project Implementation Team within the Project Management Office on health plan development priorities, and oversee project status reports and resource management Leads key governance meetings related to Medicaid.Įvolves the Medicaid ACO program to incorporate substantial health plan operations.ĭirect health plan development activities, such as defining business requirements and partnering with health plan team to implement health plan functions Prepares financial opportunity and risk analysis to recommend program objectives to senior leadershipĭirects budget development, contract management, and financial reporting related to the Medicaid ACO programĬollaborates with all necessary departments (Care Management, Performance, Analytics, Finance, IT, Strategy, and Policy) to resolve complex issues related to the initiatives and programĬreates, interprets, and disseminates information across multiple internal and external stakeholdersĮnsures compliance with all Medicaid ACO Agreement requirements and applicable laws, rules, and regulations Grows and directs the Medicaid ACO program, including: This role is also responsible for the planning and implementation of health plan development-related activities. Position Purpose: The Director of Medicaid Accountable Care Organization provides leadership and day-to-day operational oversight of Steward’s Medicaid ACO program. 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. With Steward in the community, all residents can be sure that there is a world-class doctor close to where they live. In addition, Steward Health Care Network promotes care coordination and collaboration within the network in order to provide high-quality, efficient care to patients. 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.
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