Provider Network Director jobs in Illinois

Are you ready to join a passionate community of people who are changing how health care is delivered? A place where you will find a career you love while truly making a difference building healthier communities. If this sounds like you, we would love to have you apply as Specialist, Provider Network Operations & Engagement with Medical Home Network (MHN)!

MHN is a not-for-profit collaborative that has fundamentally changed how care is delivered. Our proven model of care unites provider communities and diverse healthcare entities around a common goal: to redesign healthcare delivery and transform the way care is managed.

THE PERKS

• Fun, challenging, and collaborative work environment with passionate colleagues that care deeply about healthcare delivery.
• Recognized as One of the Best Places to Work in Healthcare by Modern Healthcare.
• Competitive benefits program including Medical, Vision, Dental, HSA, FSA, and 401k.
• Fitness reimbursement, commuter benefits, and tuition assistance.
• Great work life benefits- Paid time off, sick time, and 12 paid holidays.
• Hybrid schedule, 2 days on site 3 days remote.

THE OPPORTUNITY:

The Specialist, Provider Network Operations & Value-based Initiatives provides key support to the MHN ACO provider network and is an essential contributor to the everyday business operations of MHN ACO. This position will be responsible for coordinating and executing critical provider relations functions and managing the implementation and evaluation of key initiatives in conjunction with the MHN Provider Network and Operations Team. This position will collaborate across MHN functions to support efforts in the context of broader network operations strategy. The Specialist, Provider Network Operations position is classified as an exempt position and will report directly to the VP, Provider Network Operations & Engagement.

WHAT YOU CAN LOOK FORWARD TO:

Responsible for overall coordination and execution of provider network operations functions and implementation and ongoing management of MHN ACO programs and services.

Program Management and Evaluation

• Participate in the development and operations of new initiatives aimed at advancing or improving upon the MHN model of care
• Manage program implementation, including coordinating across teams and with external partners
• Develop and improve upon existing frameworks for the evaluation of programming including identifying areas for improvement, measuring return on investment, setting and tracking key performance indicators
• Present findings to internal and external stakeholders

Home Relationship Management

• Network Inventory and contact management – create and maintain inventory of services and resources at each Medical Home and manage key contacts within the MHN Salesforce environment
• Engage medical homes in data and analytics, schedule frequent check-ins with operational leadership
• Support reporting suite refinements and informatic design and packaging of network cost, utilization, and other executive level managed care performance reports; including the dissemination and communication around reports
• Engage members in MHN analytics, including providing MHN secure file transfer platform (SFTP) support to external users and assist with ongoing user management
• Contribute to the design, development, and production of annual Medical Home meetings – admin, scheduling, coordination with MHN departments, production of materials, participation in the onsite meetings, and follow up steps after the meetings
• Represent MHN Provider Network Ops team internally at various internal meetings, and externally at relevant MHN ACO governance committee or workgroup meetings
• Manage and exchange provider rosters and documents with MCOs and external partners or stakeholders

Tracking and Market Research:

• Focusing on key initiatives, such as Medicaid Open Choice or Medicaid Redetermination, Medicare ACO REACH Voluntary Alignment and other government program updates to identify opportunities for further engagement and increased operational support
• Tracking, Analyzing, and synthesizing information related to;
• MHN & MHN ACO growth opportunities or areas of interest
• CMS policy changes regarding the Medicare and Medicaid and relevant government programs
• Illinois HFS policy changes related to Medicaid, covered populations, and Medicaid managed care
• National, State, and Cook County Medicaid redetermination trends and policy tracking
• Changes in the national, state, and local political landscapes
• Other programmatic research relevant to the operations of MHN and MHN ACO
• The FQHC landscape, nationally and locally, including relevant regulatory or legislative developments
• Track, aggregate, and analyze FQHC UDS and Quality performance metrics and other relevant data

MHN ACO Board and Committee support

• Oversee meeting scheduling and assist with material production for ACO Board and Committee meetings:
• ACO Board of Managers – quarterly or more often
• Network Management Committee – quarterly or more often
• Growth and Retention Workgroup – quarterly or more often
• Support drafting and oversight of governance meeting minutes
• Uses, protects, and discloses MHN ACO patients’ protected health information (PHI) only in accordance with Health Insurance Portability and Accountability Act (HIPAA) standards

WHAT YOU’LL NEED TO SUCCEED:

• BA required
• Master’s in Public Health, Public Policy, Health Management, or similar field preferred
• 2 or more years relevant industry experience
• Experience implementing, managing, evaluating programs or services
• Experience with provider network management and engagement
• Excellent written and verbal communication and presentation skills
• Proficiency with Microsoft Teams and Office Suite including: Word, PowerPoint, Excel, and Outlook
• Knowledge of healthcare data and provider data, including 3rd party data sources
• Excellent client/customer service orientation
• Ability to manage multiple priorities and lead projects that span cross-functional teams
• Ability to interface professionally and personably with a variety of individuals including senior level executives, care management leads, and other clinic staff
• Ability to prioritize and work under deadlines
• Must be detail oriented
• Prior Salesforce knowledge and proficiency preferred
• Health Plan or Managed Care experience preferred

Medical Home Network is an equal opportunity employer. We evaluate qualified applicants without regard to race, color, religion, age, sex, sexual orientation, gender identity, national origin, disability, veteran status, or any other protected characteristic. This policy applies to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absence, compensation and training.