The Senior Director is responsible for staff oversight, operations and resources to ensure optimal result and high employee engagement. The Senior Director ensures that the department is run according to institutional policies and any applicable regulatory requirements. This position serves as a business lead for key operational leadership.
Duties and Responsibilities
1. Responsibilities include developing a comprehensive knowledge of MSBI hospital and physician practices to support a physician-led provider organization focused on improving care quality and costs; working closely with technology teams during the IT implementation phase essential for the proper administration and operations of the department; develop and manage a physician engagement and partnership strategy focused on creating a sense of community and improving MSBI’s market share; and to develop and direct implementation of adequate provider education/training activities for participating providers to assure provider satisfaction and issue resolution.
2. Oversees operations within Mount Sinai BI; uses data and fact-based problem solving techniques to improve processes and outcomes. Ensures that all operations run according to institutional and departmental policies and in accordance with any government or regulatory requirements as applicable.
3. Recruits, orients, trains, coaches, counsels, mentors, disciplines, and evaluates staff in accordance with all internal policies and procedures. Communicates values, strategies, and objectives of department or division on a regular basis. Assigns accountabilities, delegates tasks and responsibilities, and plans, monitors and appraises job performance.
4. Develops, maintains and reconciles departmental budget with financial responsibility and oversight for department or division.
5. Plans, develops, and/or maintains departmental standard operating procedures. Regularly reviews policies and procedures and makes changes, or recommends changes to superiors as necessary.
6. Maintains professional and technical knowledge by attending educational workshops; reviewing professional publications; establishing personal networks; benchmarking state-of-the-art practices; participating in professional societies.
7. Provides leadership for staff members in the form of ongoing training, performance feedback, goal setting, and problem resolution; cultivate a culture of innovation and creativity in service of better patient care.
8. Works directly with the Chief Administrative and Contracting Officer and VP, Community Practice Services to identify high impact operational initiatives.
9. Communicates throughout the organization and to providers on issues related to payer contracts, payer policies and procedures.
10. Engages and communicates with providers in the regarding participation requirements, clinical performance targets, care gaps and patient engagement opportunities, and clinical programs/resources.
11. Develops presentations to communicate the goals and progress of various initiatives to leaders across the Population Health enterprise, the broader Mount Sinai Health System, and with key external stakeholder groups. Deliver presentations to internal and external stakeholders as required.
12. Establishes and maintains collaborative relationships within and outside of the Health System in order to support initiatives.
13. Ensures state-specified network access and availability is monitored and maintained; related policies are maintained for process control and audit reference; and works with network recruitment team to close provider network gaps.
14. Maintains up to date competitive information including competitors’ network composition, provider reimbursement and incentive arrangements, medical and utilization management practices, technology and electronic communication methods used by competitors in support of their network providers.
15. In partnership with value based contracting lead, engages providers regarding value based contract participation and contract details.
16. Ensures staff is trained to support and service providers in value based relationships. Leverages resources with reporting and care management subject matter experts to support the training and education of field and support staff.
17. Directs the implementation and ongoing process of provider education and training.
18. Directly influences decisions related to contracting and provider relations.
19. In collaboration with Director of Communications and Director, Provider Data Management and Credentialing, oversees provider notifications and communications, provider satisfaction surveys, regular provider panel status verification, provider roster validation, provider claim issue support beyond the Financial Billing department and credentialing issues.
20. Implements programs and tactics to improve engagement of employed physicians.
21. Partners with internal teams to improve alignment, communication and engagement across markets.
22. Shares appropriate data with providers to demonstrate how the methodology MSBI is using has driven improvements in overall performance and improved finances, to engage provider support.
23. Serves as an integral part of the MSBI leadership team to review potential areas of improvement and make recommendations as part of the overall plan of action.
24. Oversight of the Provider Engagement field team to assure a consistent standard of engagement in the field and promotes and transfers best practices to all team members. This includes maintaining effective and flourishing business relationships/partnerships with providers; recruiting targeted new providers; and ensuring the Provider Engagement field staff serves as the primary advisor to their assigned practices.
25. Oversight of the in-house Provider Services team responsible for administration and the management of the day to day operations including but not limited to, questions regarding various contracts, claim or billing issues, participation status and general business issues.
26. Assures the processes of the provider engagement field team and the in-house provider services team are aligned.
Bachelor’s Degree Required, Master’s Degree Preferred.
· Minimum of 7 years of experience in provider and health care management, demonstrating leadership ability in creating and implementing strategic initiatives in provider network management, provider relations and contracting.
· Minimum of 7 years’ experience in health care operations.
· Experience with integrated healthcare delivery systems is desirable.