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Point32Health Senior Manager, Integrated Care Management – Social Work for SDOH-Health Equity in Canton, Massachusetts

Who We Are

Point32Health is a leading health and wellbeing organization, delivering an ever-better personalized health care experience to everyone in our communities. At Point32Health, we are building on the quality, nonprofit heritage of our founding organizations, Tufts Health Plan and Harvard Pilgrim Health Care, where we leverage our experience and expertise to help people find their version of healthier living through a broad range of health plans and tools that make navigating health and wellbeing easier.

We enjoy the important work we do every day in service to our members, partners, colleagues and communities.

Under the direction of the Director, Integrated Care Management for Social Determinants Of Health (SDOH)-Health Equity Population Health Management, the Senior Manager, Integrated Care Management for SDOH-Health Equity, oversees, monitors, coordinates and supervises the daily operations of the SDOH-Health Equity integrated care management teams for Point32Health’s populations. In collaboration with the Director leads the strategy and development of the SDOH-health equity plan. The Senior Manager will focus on business execution as well as employee enablement to enact SDOH-Health Equity interventions. The Senior Manager will also play a key role in, and work closely with, Point32health’s Health Equity advisory council and steering committee, supporting health system SDOH-Equity programs and policies in partnership with internal stakeholders and state and federal agencies.

The Senior Manager, Integrated Care Management for SDOH-Health Equity is responsible for the leadership, management, and oversight of 3 to 5 multi-level teams comprised of Community Health Worker’s (CHW) Managers, their direct reports and a team of front-line staff who will have responsibility for the day-to-day management and oversight of the CHW Managers within the integrated Care management teams. Provides guidance to the CHW Managers and is accountable for the outcomes of three to five CHW teams, ensuring that the teams meet the Key Performance Indicators (KPI’s) set out by the organization. Responsible for ensuring integration between the CHW function and Primary Care delivery throughout Population Health Integrated Care management.

The Senior Manager will work with the Director of SDOH-Health Equity to identify communities, stakeholders, health care professionals, and internal partners to advance SDOH-Health Equity work across all departments to ensure populations impacted by health inequity achieve their highest level of health and quality of life possible. The Senior Manager will work with the Director of SDOH-Health Equity to align Population Health Management PHM’s policies, procedures, workflows, SDOH and health equity initiatives to the larger Point32Health vision for community- based health. She/He will be instrumental in identifying gaps in health equity and assessments of member SDOH. Collaborates with other departments within the Population Health Divisions as well as with other enterprise functions, such as Member and Provider Services, Utilization Management, Behavioral Health care, and Product, to ensure that departmental and organizational goals and objectives are met. Represents Point32Health with External Stakeholder meetings including key accounts, providers, and vendors. This role has direct line management and leadership for multiple SDOH-Health Equity integrated care teams, and is responsible for the ongoing performance management, growth, and professional development of the teams.

Key Responsibilities/Duties – what you will be doing

  • In collaboration with the Director of SDOH-Health Equity oversees the SDOH- Health Equity strategy and execution related to addressing sdoh-health equity concerns across all line of businesses, including the population’s needs, trends and patterns that may impact outcomes, experience, and cost of care through in-depth analyses and prioritization of strategies that drive social transformation through a comprehensive membership population

  • Provides leadership, individually and through direct reports (Including 3 to 5 multi-level teams comprised of Community Health Worker’s (CHW) Managers, their direct reports and a team of front-line staff) to meet the Social Determinants of Health (SDOH) and Health Equity plan metrics set by Point32Health Leadership, all while remaining aligned with Point32’s mission and values.

  • Interacts with public and private sectors, forming collaboration and partnership to support broad multi-stakeholder initiatives of the social determinants of health and related activities.

  • Accountable for supporting Point32health Leadership and clinical teams in achieving KPI’s associated with the Clinical Enterprise: Including lead and lag measures such as admission/readmission rates, total medical expenditure, Minimum Data Set (MDS) timeliness, closing of Healthcare Effectiveness Data and Information Set (HEDIS) quality gaps and supporting the Social Determinants of Health (SDOH) needs of our members.

  • Engages cross-functional leaders and external stakeholders including partnering with Aging services access points (ASAPs), Independent Living Centers, Point32health’s community partners and community providers of psycho-social supports to enhance communication and relationships across the organizations and to support the highest level of care delivery to point32health’s member.

  • Acts as a liaison and maintains good working relationships with external collateral providers such as ASAP’s, community support services and state agencies.

  • Makes recommendations to leadership on approaches to enhance the effectiveness of CHW practice and programs.

  • Identifies and fosters career development and advancement opportunities for members within the team.

  • Provides monthly Care Management report on team’s performance, metrics, and goal achievement to the Director of SDOH-Health Equity, Integrated Care Management, Creates and publishes a monthly SDOH-Health Equity Integrated Care Management Dashboard.

  • Support quality improvement initiatives and medical expense reduction activities through the development of appropriate SDOH-Health Equity protocols and integrated care management strategies aligned with National Committee for Quality Assurance (NCQA) measures for all lines of businesses (LOBs).

  • Supports and conducts regular SDOH-Health Equity meetings with key constituents to build relationships, share best practices and SDOH-Health Equity tactics, develop a SDOH-Health Equity plan, and provide quality resources or services that add value for the members.

  • Partners with business unit leaders on integration of SDOH-Health Equity goals in annual business planning.

  • Maintains Health Equity plans required by state and federal agencies including Centers for Medicare and Medicaid Services (CMS), Mass Health, Department of Health & Human Services (DHHS) in New Hampshire and oversees the Equity requirements for NCQA accreditation.

  • Partners with data analytics team to inform SDOH-Health Equity interventions focused on improved access and outcomes.

Qualifications – what you need to perform the job

  • Bachelor’s degree, in Social Work, Mental Health, Psychology, Public Health, human services, or related field required

  • Master’s degree is desirable

  • 10+ years of related experience, 5+ management

  • Minimum of 6 years of progressive relevant direct member/community collaboration to meet social needs; and 5 years of supervisory/management experience in a healthcare environment required

  • Proven skills, knowledge base including knowledge of housing resources, Community Based Organization (CBOs), and community services, and judgement necessary for independent decision making

  • Proven ability to collaborate effectively as a part of an interdisciplinary team

  • Proven ability to build and sustain successful partnerships at the local, regional, and national level

  • Proven ability to create new initiatives to improve the negative health outcomes, and decrease unnecessary and preventable Emergency Department/Inpatient (ED/IP) hospitalizations related to Unmet HRSN needs

  • Experience with contracts and subcontracting, electronic grants administration.

  • Excellent writing and communication skills.

  • Experience developing grant applications and managing grant awards.

  • Demonstrated understanding and proficiency in the principles, concepts, and techniques of health care management principles

  • Proven ability to provide vision and inspiration to front line staff, set expectations, evaluate employee performance, and provide recognition for results.

  • Displays original thinking and creativity; Meets challenges with resourcefulness; Generates suggestions for improving work; Develops innovative approaches and ideas; Includes an analytical and data driven approach with critical thinking

  • Clearly and persuasively communicate, listen, and seek clarifications; participate in meetings, write clearly and informatively.

  • Able to multitask in a changing work environment. Manage competing demands and unexpected events. Willing to change approach to best fit the situation. Work cooperatively as a team member across multiple levels within the organization.

  • Results orientation - drives to exceed business-driven goals

  • Systems thinking – must understand overall Point32Health systems/people and the internal and external impact of business changes.

  • Can convey the importance of each employees’ roles with focus on improving the lives of our customers.

  • Influencing others – particularly those outside of direct reporting relationships.

  • Demonstrates collaborative approaches to problem solving with peers and other members of leadership.

  • Consistently conveys a positive can-do professional attitude.

  • Working knowledge of industry standards including but not limited to NCQA and HEDIS measures.

  • Bilingual – English/Spanish, or Portuguese preferred

DISCLAIMER

The above statements are intended to describe the general nature and level of work being performed by employees assigned to this classification. They are not intended to be construed as an exhaustive list of all responsibilities, duties and skills required of employees assigned to this position. Management retains the discretion to add to or change the duties of the position at any time.

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Commitment to Diversity, Equity & Inclusion

Point32Health is committed to making diversity, equity, and inclusion part of everything we do—from product design to the workforce driving that innovation. Our DEI strategy is deeply connected to our core values and will evolve as the changing nature of work shifts. Programming, events, and an inclusion infrastructure play a role in how we spread cultural awareness, train people leaders on engaging with their teams and provide parameters on how to recruit and retain talented and dynamic talent. We welcome all applicants and qualified individuals, who will receive consideration for employment without regard to race, color, religion, gender, gender identity or expression, sexual orientation, national origin, genetics, disability, age, or veteran status.

COVID Policy

Please note: As of January 18, 2022, all employees — including remote employees — must be fully vaccinated. This position will require the successful candidate to show proof of full vaccination against COVID-19. Point32Health is an equal opportunity employer, and will consider reasonable accommodation to those individuals who are unable to be vaccinated consistent with federal, state, and local law.

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