Strength Through Diversity
Department of Social Services (MSH) - Req Number: 2457840
Job Title: Program Manager – Health Home
Mount Sinai Health Home (MSHH) is an integral part of Mount Sinai Health Partners (MSHP). MSHH is a NYS Department of Health (DOH) program designed to serve Medicaid/Medicaid Managed Care enrollees who have high-cost and complex chronic conditions. MSHH, a patient-centered program, is a care management service model which aims, through improved care coordination and service integration, to control future health care costs and improve health outcomes for this population. MSHH is has been serving adults since 2013, and the Mount Sinai Health Home serving children was designated in 2016. MSHH care management services are performed by internal social workers and care coordinators, as well as care managers from over 25 care management agencies (CMAs). Serving over 5,000 patients, these care managers are expected to ensure that patients “receive everything necessary to stay healthy, out of the emergency room, and out of the hospital.”
The Program Manager will provide the necessary management, administrative support, and oversight for the program acting as a principal contact to various stakeholders including managed care (payers) and state government.
This position will be primarily based at 320 E. 94th Street between First and Second Avenues; some travel throughout boroughs may be required for off-site meetings with stakeholders.
• Support strategic operations through participation in MSHH Weekly Team Operations Meetings and various process improvement activities and workflow development.
• Develop and maintain knowledge and expertise of IT platform, DOH reporting, data exchange processes, and current regulations and technologies related to program data management (MAPP – Medicaid Analytics Performance Portal; RMA – Roster Management Application etc.)
• Implement best practices in data management to ensure the integrity of the data, the quality of data processes and deliver analyzable or analyzed data to a variety of internal and external stakeholders.
o Lead data and operational needs regarding program performance data, including development of performance reports, strategies for network improvement, and relationship/data exchange management with stakeholders
o Completion of standard and ad hoc reports for senior leadership inclusive of Health Home quality metrics, deliverable and enrollment metrics to inform strategic operations.
• Serve as lead contact/program representative for:
o contracted IT platform vendors inclusive of leading weekly calls, driving development priorities, troubleshooting issues, and maintaining vendor relationship
o payers, inclusive of leading monthly calls, representing program priorities, maintaining relationship and partnerships
o Stakeholder workgroups such as the MAPP/IT/Data Exchange Subcommittee and Coalition MAPP Subgroup
• Manage key program strategic operations, including patient identification strategies, payer outreach strategies, PPS and MSHP priority alignment
• Act as project manager for new and special projects, including outreach optimization, payer initiatives, and MSHP initiatives
• Support CMA Network with operational and strategic initiatives including:
o Management of inquiries and troubleshooting via phone and email.
o Provision of training and support related to IT platform and data issues, includes maintenance of platform training manual
• Promote positive relationships with Mount Sinai Health Home, Mount Sinai Health Partners, and Mount Sinai Health System, as appropriate, in all external community and government settings.
• Provide ancillary support to MSHH’s Quality Monitoring Program (QMP) to help ensure operational targets and reporting requirements are met or exceeded.
• Contribute to special projects and performs other duties as needed.
• Demonstrated leadership experience in innovative programs with complex operational and regulatory requirements preferred.
• Strong interest in being part of an innovative initiative to improve the quality and cost of care.
• Ability to review and analyze complex data to inform Health Home programming required.
• Proficiency in Microsoft Excel required.
• Excellent written and verbal communication; able to summarize analyses in a way that simplifies complex ideas and synthesizes information into insights.