Director, Population Health

Boston, MA, United States

POSITION SUMMARY:

The Director of Population Health is a key leadership position in the Population Health Services Division at Boston Medical Center Health System (BMCHS). The Population Health Services Division serves as the central hub for programs that drive performance in the Medicaid ACO. As a Senior Leader in the Population Health Services Division, the Director of Population Health will define strategic priorities across key performance drivers and oversee implementation and performance management at ACO partners.

As part of the new MassHealth initiative to transform healthcare via formation of Medicaid ACOs, Boston Medical Center Health System has partnered with providers across the state to share risk in caring for Medicaid populations. In order to succeed in the Medicaid ACO, BMCHS is rapidly designing and implementing a number of programs that improve quality of care for Medicaid populations, reduce health inequities, as well as manage utilization and total cost of care.

The Director of Population Health will support performance for the Medicaid ACO program broadly, and will specifically oversee the ACO Health Equity Program for all of BMCHS's ACO Partners in coordination with BMCHS's Health Equity Accelerator and the Population Health quality team. As part of the new 1115 Medicaid waiver launched in 2023, MassHealth created a new health equity-focused incentive program to encourage both ACOs and hospitals to advance health equity through initiatives such as demographic data collection, implementing quality interventions specifically designed to address health disparities, health-related social needs screening, expanding access to language services, improving care for patients with disabilities, and providing health equity-focused staff training. Working closely with the Population Health Senior Director of Quality and the Executive Director of Medicaid ACOs, the Director of Population Health will lead the development of strategies to implement health equity initiatives across BMCHS's ACO Partners and lead all health-equity related support for ACO Partners.

Position: Director

Department: Population Health

Schedule: Full Time

ESSENTIAL RESPONSIBILITIES / DUTIES:

Specific program oversight may include, but is not limited to:

Health Equity: The Director will lead all aspects of BMCHS's Health Equity support for ACO Partners including supporting their efforts to maximize incentive earnings, meet all MassHealth requirements for ACO providers related to health equity, and implement high-impact initiatives designed to advance health equity.

Account Management: The Director will be the primary BMCHS point person for managing performance at a set of ACO Partners. The Director will develop close partnerships with local group leaders, and collaborate closely on the initiatives listed above. In order to be an effective partner to ACO Partners, the Director will be expected to spend time on-site with designated groups.

Complex care management operations : BMCHS will deploy Complex Care Management teams across ACO provider sites. Teams will be comprised of Nurses, Pharmacists, and Community Wellness Advocates, and they will manage the top 2-3% of high risk patients at each site. The Director will partner with BMCHS clinical leaders and local site clinical leaders to manage the Complex Care Management program, which may include: ensuring smooth integration with local site care management programs, analyzing cost and outcomes data to identify opportunities for program improvement, connecting with local community partners, and ensuring optimal program operations.

Quality improvement : The MassHealth ACO program includes a full set of quality metrics. The set of quality metrics encompasses a broad range of focus areas including adult primary care, pediatrics, behavioral health, and other outcomes-based measures. In partnership with Quality leaders at BMCHS and ACO partners, the Director will help define and execute a Quality program performance strategy.

Accurate Risk Adjustment: Performance targets in the MassHealth ACO program are in part determined by the assigned risk level of the attributed population. The Director will be responsible for defining a network-wide framework for accurate risk coding

Specific duties and requirements:

Health Equity :

Develop strategies to maximize Health Equity incentive earnings across BMCHS ACO Partners including through BMCHS efforts (incl. WellSense Health Plan) or local provider efforts

Work with ACO partners and their local management teams to develop and implement strategies, initiatives, and approaches to advance health equity within their health systems

Support ACO Partners in collecting and analyzing demographic data to identify disparities and opportunities to improve care

Monitor performance on health equity-related metrics (e.g., receipt of interpreter services, RELDSOGI data completeness, quality metrics by sub-populations) and take action to improve performance in line with goals.

Partner with other BMCHS leaders to engage MassHealth leadership and staff on the structure and substance of the Health Equity program

Coordinate with relevant subject matter experts at BMCHS including the Health Equity Accelerator and Population Health Analytics

Facilitate the collection and sharing of best practices around health equity topics across ACO Partners to advance shared learning and performance improvement

Represent BMCHS at external forums related to health equity and/or population health

Ensure ACOs meet all health equity contract requirements

Serve as an advisor to other members of the Population Health team to embed a health equity lens in their work

Data and Analytics: Partner with Clinical and Financial Analytics teams to define opportunities to optimize ACO program performance; robust data analytics skills required

Translation of data into program actions: Ensure ACO programs are data-driven; translate data-driven insights into clear priorities and interventions.

Program Operations: Optimize operations and management of on-the-ground programs.

Local site engagement and communication: Ensure local site leadership is appropriately linked with BMCHS leaders and programs; build rapport, trust, and effective working relationships with their local sites.

Program design: Partners with Clinical leaders to constantly evolve and innovate on ACO program models; review data, test interventions, and define an improvement plan to ensure ACO programs are able to adapt and adjust as the ACO program evolves.

ACO program management: Develops program performance standards in conjunction with the BMCHS and local site management teams. Monitors program performance regularly against those standards and prepares and implements steps to bring the local program into conformance with those standards.

Supervising Direct Reports: depending on business need, hire, develop, and/or manage selected staff focused on Health Equity, ACO Partnership Operations, or other Population Health functions.

Performs other duties as needed

JOB REQUIREMENTS

EDUCATION:

Bachelor's Degree of Arts or Science or equivalent work experience.

Master's Degree in Healthcare Administration, Business Administration, or related fields strongly preferred.

EXPERIENCE:

Requires a minimum of 7-10 years of experience in a healthcare business environment with 3-5 years management experience.

Experience in healthcare strategy or consulting is preferred.

Experience managing an outpatient clinical setting, managing an ACO, or knowledge of the MassHealth ACO Program is preferred.

Equal Opportunity Employer/Disabled/Veterans

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