Wentworth - Douglass Hospital

Prioritize and vet a focused set of key performance indicators across the department including utilization management, quality, appeals and grievances, and pharmacy. Convene stakeholders to monitor current state and discuss interventions. Oversee strategic initiatives such as utilization management efficiency investments. Develop effective relationships with leaders and staff in the Health Plan and with Population Health Management. BSN with 5+ years’ experience in Managed Care or Healthcare Administration (Masters preferred).

senior manager

The Senior Clinical Operations Manager will work closely with the Executive Director of Operational Excellence to improve focus and execution in the Clinical department and manage strategic and high visibility initiatives. Principal Duties and Responsibilities: Indicate key areas of responsibility, major job duties, special projects and key objectives for this position. These items should be evaluated throughout the year and included in the written annual evaluation. Establish framework and manage performance for clinical department <ul><li> Prioritize and vet a focused set of key performance indicators across the department including utilization management, quality, appeals and grievances, and pharmacy</li><li> Establish targets which support company goals and regulatory requirements</li><li> Identify industry benchmarks</li><li> Convene stakeholders to monitor current state and discuss interventions</li><li> Drive solutions to improve performance </li></ul>Establish departmental goals and support leaders in cascading to unit objectives <ul><li> Work with Executive Director and Chief Medical Officer to establish and prioritize Clinical departmental goals which clearly connect with overall health plan objectives</li><li> Work with individual unit leaders to identify and prioritize objectives which support Clinical departmental goals</li><li> Create an approach which allows department to monitor goals and potential risks, and a framework for assessing the potential for reprioritization</li><li> Report on goal performance to senior leadership </li></ul>Model and promote improvement activities within department <ul><li> Work with Executive Director to implement best practices and improvement activities</li><li> Create and deploy templates to refine and standardize communication with senior leadership</li><li> Perform root cause analysis of high priority issues</li><li> Process map current and future state workflows and organizational designs</li><li> Improve meeting management, agenda setting and action items</li><li> Establish case studies and panel interviews as part of hiring process for clinical staff</li><li> Keep up to date on general best practices and those within the healthcare industry </li></ul>Manage high profile strategic initiatives and monitor risk of all clinical initiatives <ul><li> Oversee strategic initiatives such as utilization management efficiency investments</li><li> Create and manage tracking tools allowing senior leaders to assess progress and risk of clinical initiatives</li><li> Work with leaders to establish huddles throughout the department to provide updates for senior leadership and staff, promote synergies and efficiencies, and communicate best practices </li></ul>Perform data and financial analysis and modeling <ul><li> Develop methodologies for evaluating and tracking the success of interventions and quality improvement initiatives, completing quantitative and qualitative analysis to support program objectives.</li><li> Interpret and summarize data using charts, graphics and text to ensure key findings are appropriately communicated in presentations and other methods.</li><li> Develop excel models for assessing the financial impact of proposed and on-going Health Plan services</li><li> Develop in conjunction with Health Plan leadership scenario modeling using claims-based, clinical, and financial data and acquiring data in cooperation with service team leaders and support staff</li><li> Perform trend analysis to identify risk and opportunities</li><li> Work to improve visualization of current reports using existing tools and new tools as they become available </li></ul>Foster collaborative relationships with customers and stakeholders <ul><li> Provide leadership and oversight in a way that promotes a supportive, respectful environment that includes training, appropriate delegation, accountability, and growth opportunities</li><li> Develop effective relationships with leaders and staff in the Health Plan and with Population Health Management</li><li> Collaborate with administrative, clinical leaders and other key stakeholders to support Clinical programs and performance improvement initiatives, understanding structured and unstructured data to determine insights and implement evidence-based interventions across stakeholder groups.</li><li> Present ideas, updates, findings, reports, recommendations, data, and analysis to various audiences to build consensus on program initiatives </li></ul>Use Mass General Brigham healthcare values to govern decisions, actions, and behaviors <ul><li> These values govern how we get our work done: Patients, Affordability, Accountability & Service Commitment, Decisiveness, Innovation & Thoughtful Risk; and how we treat each other: Diversity & Inclusion, Integrity & Respect, Learning, Continuous Improvement & Personal Growth, Teamwork & Collaboration </li></ul>Work with Executive Director on special projects and high-profile initiatives Qualifications: (Must be realistic, neither overstated nor understated, and related to the essential functions of the job.) <ul><li> BSN with 5+ years’ experience in Managed Care or Healthcare Administration (Masters preferred).</li><li> Strong organizational and project management/operations responsibilities experience required, preferably in a healthcare setting.</li><li> Proficient with MS Office Suite.</li><li> Experience with process improvement activities.</li><li> Experience presenting to senior leaders. </li></ul>Skills/Abilities/Competencies: (Must be realistic, neither overstated nor understated, and related to the essential functions of the job.) <ul><li> Demonstrate Mass General Brigham Health Plans core brand principles of always listening, challenging conventions, and providing value.</li><li> Bring fresh ideas forward by listening to and working with employees and the people we serve.</li><li> Respect the talent and unique contributions of every individual and treat all people in a fair and equitable manner.</li><li> Strong, demonstrated track record of an ability to execute on time, on budget, and on scope.</li><li> Strong aptitude for technology-based solutions.</li><li> Ability to inject energy, when and where it’s needed.</li><li> Current in healthcare trends.</li><li> Demonstrated forward, visionary thinking; ability to see “what is” and envision “what could be.”</li><li> Ability to develop, introduce, defend, and gain support for a new ideas and approaches.</li><li> Excellent leadership skills and leadership track record.</li><li> Ability to translate and communicate complex topics in a variety of forums, tailoring communications to effectively fit and influence the targeted audience, strong executive presence, presentation, and communication skills. Strong verbal, active listening, and written communication skills required.</li><li> Ability to view the long-range trends and cycles of the business and industry and see the “big picture.”</li><li> Ability to apply a variety of strategic frameworks to analyze problems and to guide and develop solutions.</li><li> Ability to challenge the status quo and drive innovative thinking and the capability to successfully implement strategy.</li><li> Excellent interpersonal skills, including the ability to influence others at all levels of an organization.</li><li> Strong EQ; exercises self-awareness; monitors impact on others; is receptive to and seeks out feedback; uses self-discipline to adjust to feedback.</li><li> Unquestionable integrity. </li></ul>Supervisory Responsibilities: List the number of FTEs supervised. <ul><li> Provide matrixed leadership to Clinical staff.</li><li> Inform, engage, inspire, motivate, and actively listen to employees.</li><li> Make decisions that put the needs of the people we serve—our members, providers, brokers, and employers—front and center.</li><li> Identify/create processes and align resources to accomplish key objectives; clearly convey and assign clear accountability for important objectives, deadlines, and expectations. </li></ul>Fiscal Responsibility: Indicate financial “scope” information, i.e.: size of budget, volume, revenue, etc. <ul><li> Support Executive Director and functional leaders in developing budgets </li></ul>Working Conditions: Describe the conditions in which the work is performed. <ul><li> Normal office working conditions.</li><li> Remote, Hybrid or onsite </li></ul>Diversity Statement As a not-for-profit organization, Mass General Brigham is committed to supporting patient care, research, teaching, and service to the community. We place great value on being a diverse, equitable and inclusive organization as we aim to reflect the diversity of the patients we serve. At Mass General Brigham, we believe in equal access to quality care, employment and advancement opportunities encompassing the full spectrum of human diversity: race, gender, sexual orientation, ability, religion, ethnicity, national origin and all the other forms of human presence and expression that make us better able to provide innovative and cutting-edge healthcare and research. EEO Statement Mass General Brigham is an Equal Opportunity Employer. By embracing diverse skills, perspectives and ideas, we choose to lead. All qualified applicants will receive consideration for employment without regard to race, color, religious creed, national origin, sex, age, gender identity, disability, sexual orientation, military service, genetic information, and/or other status protected under law. We will ensure that all individuals with a disability are provided a reasonable accommodation to participate in the job application or interview process, to perform essential job functions, and to receive other benefits and privileges of employment. Disclaimer The above statements are intended to describe the general nature and complexity of the work being performed by personnel assigned to this classification and do not represent an exhaustive list of all tasks, duties, and responsibilities required of personnel assigned to this position. Primary Location NH-Dover-WDH Main Hospital Work Locations WDH Main Hospital Job Nursing-Management Organization Wentworth-Douglass Hospital(WDH) Schedule Full-time Standard Hours 40 Shift Day Job Employee Status Regular Recruiting Department WDH WDPC Administration Job Posting Mar 8, 2024

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