Manager Network Performance-SWHR CIN at Southwestern Health Resources CIN in Pittston, Pennsylvania

Job Description:

Southwestern Health Resources Clinically Integrated Network (SWHR CIN), is hiring for a Manager Network Performance.

This position will be accountable for driving performance improvement for SWHR Primary Care Physicians and advanced practice providers (APPs) within key domains (e.g., RAF, Quality, Cost Efficiency, Network Efficiency) through the implementation of a systems-based data-driven approach. The PI Manager will be responsible for developing KPIs, monitoring performance for a "panel" of physicians and leveraging a team of physician relationship managers to drive tailored improvement strategies that acknowledge the diverse nature of SWHR PCP practices in their size, maturity and familiarity with value based care.

Location: Farmers Branch

Core Hours

• Full time, Monday through Friday, 8am-5pm

Job Description

Operations:
Develops team goals that will drive favorable results for SWHR and physician practices.
Reviews and develops physician engagement policies/procedures/guidelines/standard work in collaboration with other departments.
Act as intermediary between SWHR, Providers, and Health Plans to research and resolve escalated provider complaints.
Thoroughly understands physician incentive programs and key levers to pull to motivate physician performance.
Ensure assigned community physicians are current on SWHR membership dues and coordinate with SWHR Finance to notify physician on dues and follow up as necessary to drive collections.
Gather, review, and verify all pertinent information related to MCOs; ensure that any updated, changes, etc. that would impact network physicians and staff are disseminated to appropriate personnel in a timely manner.

Strategic Initiatives:
Responsible and accountable for translating goals into executable projects/initiatives and oversee timely completion with high quality outcomes.
Analyzes and utilizes data to facilitate targeted performance interventions aimed at improving physician experience and patient care.
Aligns strategy and planning with organizational initiatives. Facilitates cross-functional improvement teams, including development of work plans, timelines, and standard work.
Builds relationships with key provider practices and executives and accompany staff on a regular basis for practice visits.
Collaborate with Director of Physician Engagement to drive desired SWHR Network Services outcomes and deliver a seamless, unified provider experience.
Takes ownership and drives accountability with each physician relationship manager to improve performance for their assigned physicians.
Develops strategies and best practices and monitors, trends, and utilizes data to drive performance improvement.

Performance Improvement:
Evaluates workflow to identify process improvement opportunities by applying Lean principles, methods, and tools to enhance team performance on quality of clinical care, efficiency, service and safety.
Recommends policy and procedure changes to improve provider experience and clinical outcomes.
Contributes to modifications in physician's practice patterns to continuously optimize patient outcomes, quality of care, workflow, use of resources and patient service.
Proactively provides reports to the external PRM Team to communicate effectively regarding program results and patient success stories.
Reports on performance of assigned "panel" of physicians with data-driven justification of trends.

Education/Training:
Plans and conducts ad-hoc education and training for physicians to meet project goals and to facilitate and support the Clinic's performance initiatives.
Empowers physician relationship managers to operate at "top of their license" through appropriate training and education on all SWHR physician facing tools, incentive programs reports, and processes.

Education
Bachelor's Degree in Healthcare, Business, Science, Marketing, Communication required
Master's Degree Healthcare, Business, Science, Marketing, Communication preferred

Experience
3 years Management experience supervising team of at least 5 staff required
5 years experience in health care, managed care, insurance or account management required

Skills
Management experience over team of at least 5 staff; experience with field-based employees a plus
Excellent oral and written communication skills
Excellent problem solving and troubleshooting skills with the ability to exercise mature judgment
Experience driving root cause analysis for physician performance improvement projects
Experience in project management and with driving program implementations delivering results per scope, timeline and budget
Ability to support development of team by setting performance standards, delivering feedback and coaching
Ability to work independently and manage multiple task assignments
Ability to work with internal business leaders on project readiness and execution
Experience participating in setting project objectives and scope
Experience developing work plans for projects, coordinating activities between work streams and identify changes in scope
Experience with building workflows and performing ad-hoc analysis
Experience summarizing results and delivering presentations to executives
High level of proficiency working with Microsoft Word, Excel, PowerPoint, Project and Visio; experience in Salesforce is a plus
Comfortable with working in a dynamic environment and setting high performance expectations for team through role model behavior
Ability to understand advanced physician incentive programs
Knowledge of risk adjustment. ambulatory quality and Medicare STARS program

Travel Requirements
Local 50% Travel to provider practices or other relevant locations in the DFW area as necessary

Southwestern Health Resources (SWHR) is a patient-centered clinically integrated network of 29 hospital locations and more than 5,500 physicians and other clinicians. Formed by Texas Health and UT Southwestern, two of the region's leading healthcare systems, SWHR delivers nationally preeminent, highest-quality care in 16 counties across North Texas. SWHR is also the parent organization of Care N' Care Insurance Co., a regional Medicare Advantage Plan serving more than 13,500 members in the region.

The SWHR network includes physicians from UT Southwestern and Texas Health, and independent community primary care and specialty physicians. In partnership, our team implements physician-driven, value-based care strategies to coordinate care for more than 700,000 patients, resulting in lower costs and high-quality care. In 2020, the Centers for Medicare & Medicaid Services released the annual financial and quality results and, based on the report, SWHR is one of the nation's leading Next Generation Accountable Care Organizations, having saved nearly $120 million since joining the program in 2017.

At the heart of SWHR are people who help people. We care about those we serve and each other. To be the national leader in providing population-based healthcare, our more than 850 employees use their knowledge, data insights and clinical experience to deliver care to the right patient, at the right time and in the right setting. By connecting physicians to patients and clinical insights to better outcomes, SWHR lowers costs, optimizes value, and builds a better healthcare system for all.

We invite you to learn more about us at www.southwesternhealth.org .

Let's move healthcare forward - together.