Manager, Network Care Coordination

Summary: The Network Care Coordination Manger controls the coordination of care within the CharterCARE Provider Group of RI (CPGRI) and CCHP networks/systems by implementing processes to ensure seamless access to health services and communication amongst caregivers.  The incumbent will support the Coordinated Regional Care (CRC) model and its goals relating to patient access, quality and patient and provider satisfaction, all in a cost effective manner, in order to provide value for the communities served.  The incumbent will manage staff, develop policies and procedures, create and monitor key performance indicators (KPIs), and ensuring a collaborative approach with providers, practice managers and support staff, as well as independent practices within the IPA.  KPIs include:

•   Referral turnaround time (consult to care)

•   Outpatient retention

•   Inpatient retention

•   Referrals processed by FTE per hour

•   Tier I network utilization

The position serves as a conduit for critical processes enabling true integration between outpatient services, network operations, acute and post-acute services. 

Education:  Bachelor/undergraduate preferred.

Experience: At least one year of relevant work/intern experience in a medical/physician’s offices, managed care, or health system operations.    

Skills and Abilities:

• Knowledge of basic software applications to include electronic health records and customer relations management.
• Knowledge working with Athena and experience with Meditech 
• Knowledge of managed care principles and risk contracting
• Skill in dealing with interpersonal issues, physicians and customer relations
• Skill in process development and improvement
• Ability to lead multiple staff/disciplines
• Ability to handle multiple priorities at once with minimal supervision
• Ability to organize, present and communicate clearly
• Ability to maintain confidentiality of patient and employee information

Working Conditions, Physical Environment and/or Safety Requirements: General pleasant working environment with little or no distractions or exposure to unpleasant or hazardous elements.  Meets all safety training requirements associated with the health system. Duties are a combination of extensive mental and manual skills.  Manual skills are required such as finger, eye and hand dexterity for such activities as utilization of a computer.