The Director of Integrated Care Management & Coordination develops and manages the Massachusetts Care Coordination Network’s (MCCN’s) integrated LTSS care management and care coordination service lines.
The main goals of the MCCN are to support MassHealth Members with complex LTSS needs and their families to help them navigate the complex system in Massachusetts; Improve Member experience and quality of care by assisting them in identifying and accessing appropriate setting and levels of care through care planning, care coordination and support during transitions in care; Support values of Person-Centeredness, Independent Living, aging in place, and cultural competence.
MA/MS or doctoral degree in health and human services or a related field.
Minimum of five years of LTSS experience, two years of care management experience, and two years of supervisory and management experience, any of which may overlap.
Training in care management and integration of medical and behavioral health services preferred.
Experience in program development, collaboration, and contract management with external customers preferred.
Experience in coordinating care for diverse populations of individuals with complex LTSS needs and in developing person-centered plans.
Ability to read and speak English.
Strongly prefer that a candidate will have a demonstrated understanding of and competence in serving culturally diverse populations.
Ability to communicate effectively verbally and in writing.
High energy level, superior interpersonal skills, and ability to function in a team atmosphere.
Commitment to MCCN values and mission.
Computer skills, preferably including Word, Excel and Outlook
Valid driver’s license and access to auto.
Ability to perform each essential duty satisfactorily.
Please note: The essential functions listed in this section are not limited only to the tasks listed and may include other duties as assigned.
Lead the development and management of MCCN’s integrated LTSS care management and care coordination service lines.
Function as MCCN’s care management and care coordination subject matter expert internally, such as through staff training, and externally, such as by representing MCCN in external venues and initiatives related to care management/coordination.
Conduct contract management of MCCN care management and care coordination contracts with various payers, including monitoring and meeting contractual requirements, communicating and meeting with payers, cultivating relationships, overseeing billing and administrative processes, and providing financial management and oversight in collaboration with other MCCN leadership staff. Ensure that the provision of care management and care coordination services meets contractual obligations.
Work collaboratively with MCCN leadership staff and Care Management Software vendor to ensure smooth implementation of the MCCN Care Management Software tool.
Work closely with Human Resources to hire, train, supervise, and evaluate care management and care coordination program staff of Seven Hills Foundation. Maintain consistent communication with staff and conduct regularly scheduled staff meetings.
Oversee the development and execution of a comprehensive marketing and outreach strategy for the MCCN’s integrated LTSS care management and care coordination service lines.
Collaborate with MCCN partners and subcontractors to provide and obtain consultation and access to services needed by persons served in the care management and care coordination programs, and jointly develop new services and supports.
Serve as the liaison to other community providers and related agencies to develop community resources, as needed to meet the needs of persons served in the care management program.
Serve as an ad hoc member of the MCCN Consumer Advisory Board and serve as a liaison between the CAB and the Governing Body.
Collaborate with the Quality Management and Corporate Compliance departments in ensuring that the provision of care management and care coordination services complies with MCCN policies, procedures and quality standards as well as licensing, regulatory, and payer requirements.
Collaborate with the Quality Management department to identify and measure care management and care coordination outcomes, consistent with the needs of persons served and the goals of payers.
Contribute to MCCN healthcare reform growth and development activities, particularly related to care management and integration.
Perform all duties in accordance with the agency’s policies, procedures and standards.