Position Summary

The Network Care Coordination Manger controls the coordination of care within the CharterCARE Provider Group of RI (CPGRI) and CCHP networks/systems by implementing processes to ensure seamless access to health services and communication amongst caregivers.  The incumbent will support the Coordinated Regional Care (CRC) model and its goals relating to patient access, quality and patient and provider satisfaction, all in a cost effective manner, in order to provide value for the communities served.  The incumbent will manage staff, develop policies and procedures, create and monitor key performance indicators (KPIs), and ensuring a collaborative approach with providers, practice managers and support staff, as well as independent practices within the IPA.  KPIs include:

 

Referral turnaround time (consult to care) Outpatient retention Inpatient retention Referrals processed by FTE per hour Tier I network utilization

 

The position serves as a conduit for critical processes enabling true integration between outpatient services, network operations, acute and post-acute services. 

  Education/Experience

Education:  Bachelor/undergraduate preferred.

Experience:  At least one year of relevant work/intern experience in a medical/physician’s offices, managed care, or health system operations.     

 

Knowledge / Skills / Abilities Knowledge of basic software applications to include electronic health records and customer relations management. Knowledge working with Athena and experience with Meditech  Knowledge of managed care principles and risk contracting Skill in dealing with interpersonal issues, physicians and customer relations Skill in process development and improvement Ability to lead multiple staff/disciplines Ability to handle multiple priorities at once with minimal supervision Ability to organize, present and communicate clearly Ability to maintain confidentiality of patient and employee information