Role Summary:
GUIDE is a new CMS program for Medicare beneficiaries with Dementia that provides access to a comprehensive model of care coordination including respite care services for patients and caregivers. By enrolling beneficiaries in this program, we will seek to improve outcomes related to quality of care and patient experience, contributing to cost savings through reductions in acute care utilization and delayed transition to long-term care.The Operations Coordinator is a central role in driving the success of our participation in the GUIDE model, and the primary point of accountability to integrate activities across the clinical enterprise and with our GUIDE partner Synapticure.
GUIDE will require collaboration across stakeholders, including our primary care network, specialists, and inpatient teams as the program is implemented and launched this summer through steady state operations and ongoing improvement. Accountable to Synapticure’s Head of National Memory Care Programs and dotted line reporting to RHN Care Management leadership, this role will lead the customization and adoption of GUIDE workflows across teams, drive awareness of the benefits of the model for providers, patients and caregivers, and ensure an exceptional experience of care from enrollment through ongoing care coordination.
The desired candidate has experience leading clinical initiatives within health systems, communicating with both executive and front-line teams across clinical, administrative and data/IT functions, and managing projects with distributed teams of in-person and virtual staff. Responsibilities
Workflow Implementation and Excellence
- Support the development and tailoring of beneficiary enrollment processes
- Coordinate referrals from PCPs and Specialists for diagnostic support and enrollment
- Coordinate and support practice education regarding GUIDE workflows
- Ensure alignment to effectively engage new enrollees and and longitudinal patients through transitions of care (e.g., ED/IP admissions)
Stakeholder Engagement
- Effectively communicate the vision for and benefits of GUIDE to executive sponsors, clinical teams, community partners, and patients and caregivers, including tailoring related materials
- Communicate regularly with stakeholders across the clinical enterprise to proactively identify opportunities for integration with the GUIDE care model
Patient Activation
- Facilitate patient data acquisition and analysis (e.g. from EHRs, claims, practice management tools, and other business intelligence) and ensure clinical teams have the necessary information
- Design patient activation strategies (e.g., collateral development, educational events, community engagement) and mobilize relevant stakeholders
Program Performance Management
- Facilitate a productive working relationship of the GUIDE Steering Committee
- Monitor and report on key outcomes (e.g., engagement, clinical quality, cost & utilization, and patient experience metrics
- Maintain operational dashboards to provide transparent KPI progress and tracking
- Identify areas for improvement based on KPIs, operational workflows, and patient and provider experiences
Qualifications
- 3-5 years of project management experience within health systems
- Demonstrated ability to engage diverse stakeholders to implement and launch cross-functional, patient-facing initiatives
- Excellent communication and interpersonal skills
- Enthusiasm about new models of care, with the ability to inspire and motivate others
- Strong problem-solving skills and the ability to anticipate and mitigate risks
- Experience with healthcare technologies and data including from electronic health records (EHRs), health information exchanges (HIEs), and medical claims data
- Proficiency with project management software, tools and methodologies (e.g., developing presentations, workflow diagrams, gantt charts, risk registers)
Desired Experience:
- Clinical training (RN, LCSW)
- Experience with CMS programs and/or healthcare regulations and compliance
- Personal commitment and passion for patients and caregivers living with Dementia
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