Team Lead, Rural Health PCMH Program

Community Health Network of Connecticut, Inc.•Wallingford, CT

About The Position

The Rural Health Transformation (RHT) Program is a federal grant that empowers states to strengthen rural communities across America by improving healthcare access, quality, and outcomes by transforming the healthcare delivery ecosystem. This role provides direct oversight on the operational functions of the CPTS staff supporting the DSS Rural Health Transformation (RHT) program in the administration and implementation of the RHT PCMH program. This includes staff oversight of achievement of PCMH deliverables while assisting practices toward obtaining and maintaining NCQA Patient-Centered Medical Home (PCMH) recognition. The role involves managing, coordinating, and documenting all program activities to ensure success, including Annual Provider Profile activities. The Team Lead communicates program status, monitors staff productivity, appointment schedules, provider practice visits, and contact log documentation, as well as NCQA PCMH recognition tasks and quality improvement activities. They support the CPTS staff to utilize data to drive improvements in health outcomes of the Medicaid population through practice transformation strategies and actionable interventions that are health equitable and complement value-based payment models. The Team Lead also serves as an individual contributor to the RHT PCMH program, skilled in and possessing content knowledge of NCQA PCMH requirements.

Requirements

Four to six years post-secondary schooling
Bachelor’s degree required
Five to seven years of related experience involving management of high visibility programs.
Strong management experience.
Thorough knowledge of program development, implementation and outcome analysis.
High level experience with managed care health care systems/processes, commercial and/or governmental programs and related processes.
Must hold a valid and unrestricted motor vehicle license and have reliable transportation.

Nice To Haves

Master’s degree preferred
Major in Nursing or Business, Health Care Administration, or related discipline

Responsibilities

Provide direct oversight on the operational functions of the CPTS staff supporting the DSS Rural Health Transformation (RHT) program in the administration and implementation of the RHT PCMH program.
Assist practices toward obtaining and maintaining NCQA Patient-Centered Medical Home (PCMH) recognition.
Manage, coordinate, and document all program activities to ensure success, including Annual Provider Profile activities.
Communicate RHTP PCMH program status to QM Team Lead/PCMH Program Administrator.
Monitor staff productivity, appointment schedules, provider practice visits, and contact log documentation, as well as NCQA PCMH recognition tasks, and quality improvement activities within the CMAP primary care practices.
Support the CPTS staff to utilize data to drive improvements in health outcomes of the Medicaid population through practice transformation strategies and actionable interventions that are health equitable and complement value-based payment models.
Serve as an individual contributor to the RHT PCMH program who is skilled in and has content knowledge of NCQA PCMH requirements.
Assure that RHT program deliverables and activities are completed timely and accurately by the CPTS staff.
Serve as a clinical resource for the CPT team.
Monitor staff effectiveness and performance while implementing processes and workflow improvements.
Meet with the QM Team Lead/PCMH Program Administrator to discuss concerns (practice findings, staffing, resource issues, etc.).
Oversee PCMH staff productivity and unit metrics assuring all metrics are met and work directly with individual staff members to address concerns within the practices.
Maintain an open line of communication to keep staff up to date on new policies and procedures/workflows.
Assign the CPTS staff their practice assignments and projects.
Coordinate staff development opportunities.
Approve staff payroll and PTO requests.
Monitor practices’ adherence to DSS RHT PCMH program requirements, including sustaining recognition and PCMH deliverables.
Survey practices to determine the level of satisfaction with RHT PCMH, QI and annual reporting supports provided by the CPT staff.
Collaborate with outside agencies to integrate initiatives with ASO and practices.
Ensure the provision of key reports to practices on a web-based portal and execute data analysis and reporting activities that guide DSS in defining payments to practices that comply with NCQA requirements and meet required levels of performance on health outcomes measures.
Provide reporting on the QI activities within the practices to positively impact quality metrics and meet CHNCT performance targets intended to improve the health outcomes of the HUSKY Health membership.
Support the QM deliverables and department activities.
Directly oversee day-to-day staff coverage and assignments.
Monitor staff productivity; working directly with individual staff members to assure that metrics are met.
Perform monthly CPTS audits to assure that documentation contains the highest of quality standards.
Attend CPT staff practice meetings to assess staff performance and provide education as needed.
Communicate effectively to provide education and guidance to the CPT staff in order for them to assist CMAP practices to successfully obtain PCMH recognition.
Oversee the implementation and ongoing operation of RHT PCMH program.
Manage the development and evaluation of business and system requirements with assigned programs.
Assist CPT program staff and guide interdepartmental goals to meet program objectives.
Anticipate and escalate for executive review the risk management, change management, and quality management issues inherent to program deliverables.
Perform related duties as assigned.
Maintain current awareness of contractual requirements, changes and industry trends, including NCQA PCMH annual Standards and Guidelines.