Provider Delivery, System of Care Manager

Newtown PA 18940

Job Description

This role supports the Sr. Director System Transformation in implementing the Customer Management Centers’ (CMC) strategic plan for Provider Delivery System Transformation. This position is responsible to support the implementation of the Customer Management Center’s (CMC) strategy activities in system transformation, helping Pennsylvania publically funded service providers deliver high value, high outcome services to members. As part of the overall CMC Strategy and System Transformation Plan this role supports the leadership team in engaging providers, county customers and state agencies in a collaborative approach to achieve the strategic goals of the CMC

Supports system transformation analysis and report interpretation.
o Works with providers and county partners to understand what type data may be helpful to support Value Based Care models, quality improvement activities to achieve performance benchmarks.
o Supports analyses of provider delivery system reports related to delivery system effectiveness.
o Works with internal Magellan departments and other state/county/local programs (as needed/appropriate) to improve data collection and data sharing capabilities.
• Assists in the identification of key business issues related to the Provider Delivery System and the design of analytic approaches.
o Conducts research on identified issues.
o Assists in developing and utilizing data gathering tools such as surveys/questionnaires, work sampling, to ensure that appropriate quantitative and qualitative data is gathered for the analysis.
• Conducts quantitative and qualitative analyses on a broad array of issues within the provider delivery network.
o Prepares interpretations of analyses for clients and/or department leadership.
o Prepares reports synthesizing analytical results, highlighting implications of findings.
• Assist with external facing provider and customer activities related to VBP and system transformation activities.
o Assists with provider education and technical assistance to support delivery system transformative activities.
o Makes suggestions of actionable interventions based upon data.
• Assists and supports effective coordination and collaboration with internal Magellan departments including, quality, network, clinical, finance and others and tapping Magellan’s subject matter experts as needed.
• Shares responsibility for effectively communicating the Provider Delivery System Transformation Plan vision and goals as it relates to the overall CMC Strategic Plan and contract deliverables under Value Based Purchasing.
• Supports the Sr. Director System Transformation in ongoing system redesign leveraging data to:
o Promote the implementation of Value Based Care models and provider partnership models.
o Supports and works with CMC partners to implement internal policies, procedures, and/or work flows needed to move toward more advanced VBP models.
o Identify opportunities and demonstrate improved quality of difficult to manage services.
o Define what evidence based practices really work in a cost effective way.
 

General Job Information

Title

Provider Delivery, System of Care Manager

Grade

27

Job Family

Operations Group

Country

United States of America

FLSA Status

United States of America (Exempt)

Recruiting Start Date

1/11/2019

Date Requisition Created

1/11/2019

Minimum Qualifications

Education

A Combination of Education and Work Experience May Be Considered., Masters: Behavioral Health (Required), Masters: Healthcare (Required), Masters: Public Health (Required)

License and Certifications - Required

License and Certifications - Preferred

Other Job Requirements

Responsibilities

Will consider bachelors degree in Behavioral Health with demonstrated experience in behavioral health Medicaid managed care. Knowledge and/or experience with Value Based Care Delivery Models preferred.

Magellan Health Services is proud to be an Equal Opportunity Employer and a Tobacco-free workplace. EOE/M/F/Vet/Disabled