Medical Management Director jobs in Illinois

Job Summary

WELLBE INTRODUCTION

The WellBe care model is a Physician Led Advanced Geriatric Care Program focused on the quality of care of the frail, poly-chronic, and elderly Medicare Advantage patients.  This population is typically underserved and very challenged with access to overall health care.   To address these problems, we have elected to bring the care to the patient, instead of trying to bring the patient to the care.  WellBe’s Care Model is to provide our members the entire continuum of care from chronic to urgent care in the home, hospital, skilled nursing facility, assisted living, palliative care, and to end of life care.  WellBe's physician/advanced practicing clinician led geriatric care teams’ partner with the patient’s primary care physician to provide concierge level geriatric medical care and social support in the home as well as delivering and coordinating across the entire care continuum.

Job Description

GENERAL SUMMARY

The Director of Neighborhood Management assumes a pivotal role in healthcare logistics, collaborating with data analytics to pinpoint statistically optimal locations for patient attribution clinical service area within our markets. This role will review all nuances impacting a market and deliver analytical decisions related to market assignments, care service areas, and evaluate and recommend best strategies across key departments to deliver the best patient engagement results. Responsibilities entail leveraging data insights to inform node placement strategies, make core recommendations for market level execution and outreach efforts, coordinate with market leadership to finalize node locations, and facilitate seamless integration of neighborhood-based patient care initiatives. The ideal candidate will possess a strong background in data analytics, healthcare management expertise, and effective communication skills to align node placement decisions with overarching organizational goals.

Job DescriptionWe are seeking a dynamic and experienced Director of Neighborhood Management to join our team. As a Director of Neighborhood management, you will be responsible for ensuring that we are planning and executing on core engagement strategies including recommendations for call list utilization, staff placement, and ideal assignment of care service areas  based on numerous factors including data, geography, staffing and attribution.    The Director of Neighborhood Management is responsible to ensure that there is full alignment between operational leadership and market execution.  

Key Responsibilities:

• Serve as the primary contact between data analytics and the market leadership team to implement recommended clinical service areas for each market on a monthly basis
• Take input from the data analytics team and translate that to a plan to present and collaborate with market leadership team
• Implement neighborhood/node change recommendations with local market leadership team in order to optimize our clinical service area placement and improve our ability to serve our patients
• Utilize quantitative and qualitative data when collaborating with market leadership on changes, especially when it comes to continuity of care for at-risk patients.
• Collaborate with local market leadership team when new clinical service areas are presumed to be needed
• Create the initial plan for each new market launch for community and node placement along with expansion plan beyond initial market launch
• Provide input and collaborate with data analytics in refining their node placement algorithm
• Provide reporting to operational leadership on status and progress towards optimal node placement and resource allocation
• Work with market teams to create a plan to transfer patients when clinical service areas are being updated, and follow-up to ensure that the plan is executed
• Develop and oversee neighborhood management department

Job Requirements

Qualifications:

Educational Requirements:

• Bachelor's degree in healthcare administration, business administration, or a related field
• Preferred: Master of Health Administration or Master of Business Administration

Required Skills and Abilities:

• Minimum of 8 years of experience in healthcare, market planning, and collaborative leadership.
• Competency in Google Workspace, MS Office software suite
• Preferred experience with HIPAA compliance rules
• Excellent understanding of data analytics with the ability to collaborate on decisions based on business needs.
• Excellent communication and presentation skills, with the ability to effectively engage with internal and external stakeholders.
• Demonstrated ability to develop and execute strategic plans to achieve organizational goals.

Travel requirements:

• Travel may be required up to 70% locally or nationally.

Work Conditions:  

• Standard office work conditions of sitting at desk and using electronic devices for long periods of time.
• Office temperatures may vary.

The preceding functions may not be comprehensive in scope regarding work performed by an employee assigned to this position classification.  Management reserves the right to add, modify, change or rescind the work assignments of this position.  Management also reserves the right to make reasonable accommodations so that a qualified employee(s) can perform the essential functions of this role.