Director of Patient Engagement Operations

Diverge Health•Chicago, IL

35d•$155,000 - $175,000

About The Position

At Diverge Health we are passionate about improving health access and outcomes for those most in need. We partner with primary care providers to improve the engagement and management of their Medicaid patients, offering independent practices with specialized resources and clinical programs to close gaps in care. Our teams work to address medical, social and behavioral patient needs, lowering healthcare costs and improving patient lives. Guided by our core values of humility, continuous learning and feeling the weight, our team is on a mission to strengthen communities from within, unlocking people's ability to live their healthiest lives. We are looking for a Director of Patient Engagement Operations to join our team! As a pivotal part of our central team, you’ll be responsible for ensuring that the operational processes that engage patients in our care model are deployed accurately at scale and continue to attract and retain patients in our care programs . You will work across a diverse set of stakeholders both centrally and across each market. You will also work closely with our Population Health, Operations, and Clinical teams, as well as our Market Presidents and local front line care teams. This role is a crucial enabler of operational excellence in our engagement with our patients and our network of primary care practices. What you'll do As a Director of Patient Engagement Operations, you will be responsible for establishing and executing Diverge Health’s centralized patient enrollment and engagement operations and for developing and deploying workflows that connect patients to the clinical programs executed in our markets. You will work closely with market leadership and Care Teams to ensure that the infrastructure and operational processes to enable the Diverge Model of Care are being implemented appropriately across markets, while simultaneously being responsive to market feedback and working around market specific nuances.

Requirements

5-7 years of experience in managing operations related to care management, care coordination, or patient recruitment, enrollment and retention within a provider or health plan setting
Ability to distill abstract concepts into concrete processes and steps
Experience working with or within a patient contact center
Ability to operate in an ever-changing environment
Experience with process design and change management
Understanding of population health management from the provider or payor vantage point
Familiarity with consumer (patient and practice) engagement
Familiarity with case management and population health best practices
Familiarity with common EMRs such as Athena, Practice Fusion, Epic and eClinicalWorks
Familiarity with Health Information Exchanges (HIEs)
Ability to receive and implement constructive feedback
An empathetic, humble, and highly conscientious teammate who inspires and motivates others
Strong ability to connect with people from all walks of life
Curious and committed to continuous learning and growth
Excellent communication skills, with strong follow-through and attention to detail
A thoughtful problem solver who brings clarity and structure to complex situations
A strong representative of Diverge Health's mission, vision, and values

Nice To Haves

Clinical experience (RN, NP, LPN, etc.) or Clinical training (e.g. Nurse Practitioner)
Experience partnering with primary care physicians or working within a physician group
Understanding of population health management from the provider and payor vantage point

Responsibilities

Design and deploy scalable operational processes that enable patient enrollment in Diverge Health’s care programs as well as ongoing engagement and progression within those programs including, but not limited to, processes to:
Ensure that data on eligible patients from new and existing sources are being activated in timely and streamlined ways such as:
Collaborate with the Payer Account Management function to intake claims and other payer data
Collaborate with the Practice Liaison function to intake electronic medical record (EMR) extracts, and direct patient referrals from network practices
Coordinate with state specific HIEs, national data providers, and the Diverge Health technology function, to obtain lab values, admit, discharge & transfer (ADT) alerts, and other clinical data
Deploy the centralized patient outreach function to generate a robust volume of interested patients for engagement by Diverge Health Care Teams
Route patients identified through various data sources, and direct primary care physician (PCP) referrals, into patient outreach workflows such as:
Close the loop between receipt of payor data, the performance of risk stratification, the initiation of patient outreach by one of our Patient Enrollment Specialists
Integrate direct patient referrals from PCPs into patient outreach workflows
Ensuring smooth handoffs from the enrollment team to appropriate Care Team members in each market
Integrating ADT alerts, lab values, and other critical data into patient outreach, Care Team notification, and practice notification workflows
Integrating quality data into patient outreach and care management workflows in support of the enterprise quality strategy
Directly manage the Patient Enrollment Specialist and Health Engagement Specialist teams, providing day-to-day support, coaching, and oversight
Generate reporting on both process and outcome metrics for internal stakeholders, as well as payer clients and network practices
Receive and process market feedback, understand when an overarching operational gap exists vs a market specific challenge
Oversee the implementation and utilization of clinical information systems and technology to support patient enrollment and ongoing engagement
Disseminate standard operating procedures (SOPs) related to patient outreach, ADT alerts, and proactive KPI monitoring to market leadership and staff
Facilitating bi-directional communication between Diverge Health’s Health Engagement Specialists and Care Teams, and network practices (both practice administrators and PCPs) for care coordination as well as more urgent patient issue escalations