Position Title	Director, Provider Services
Work Location	Silver Spring, MD
FLSA Status	Exempt
Full-Time or Part-Time	Full-Time
Telecommuting	No/Occasional

 

POSITION SUMMARY

This position has both strategic and operational responsibilities. The position serves as the senior subject matter expert on primary care practice and provider network transformation. Along with the VP Healthcare Initiatives, this position develops and implements a strategy for the growth and sustainability of the network of providers who serve over 25,000 low-income, culturally and linguistically diverse adults in Montgomery County. This position leads the Provider Services team, which is responsible for provider recruitment and retention in the networks; education, training and process improvement activities with providers; provider payment processing; and contract compliance and reporting.

In addition, the Provider Services team focuses on providers’ meaningful use of EHR (eClinicalWorks/eCW), accurate data capture, provider quality assurance and safety-net provider long-term business sustainability The Director of Provider Services ensures compliance with the PCC-DHHS Montgomery Cares contract, serves as a liaison to DHHS staff, the network of community based clinics, and other community based organizations. The Director Provider Services supervises the Provider Services team and works closely with the Manager Community Based Health informatics, the Director Quality/Clinical Services, and Director External Affairs/Strategy on advocacy efforts.

PRIMARY RESPONSIBILITIES

• Participate in the ongoing development of a primary care safety-net network with the geographic reach, access hours, and cultural and linguistic competence to meet patient primary care needs and reduce Emergency Department use among low income, vulnerable populations.
• Support the development of standards for network participation.
• Provide leadership to support the adherence to standards, while respecting the historical and environmental realities of the safety-net provider landscape.
• Serve as liaison to safety-net providers, Montgomery County Department of Health and Human Services (DHHS), and advisory groups such as the Montgomery Cares Advisory Board. Liaise with emerging providers types (e.g. retail and urgent care centers) and evaluate potential for network relationship.
• Envision opportunities for network strength and cohesion (e.g. shared services or contracting, central support services). Build support for and implementation of these models where appropriate for network strength.
• Develop the MCares program to align with current healthcare trends including essential services and value based reimbursement strategies.
• Lead the Provider Services Team (with team staff and consultant experts) in provision of practice transformation support to safety-net primary care providers to insure the strength and sustainability of providers in the network. Team responsibilities include:
• Assist providers to understand their current business landscape and options for market niche and growth areas; assist them with plans for growth and financial sustainability.
• Together with Practice Management subcontractor, assist practices in developing a viable payor mix (Medicaid managed care at least 10%).
• Identify business drivers for safety-net providers: assist provider to grow their analytic, forecasting, and business planning skills.
• Capture baseline data on metrics and create processes for regular reporting to provider management.
• Continuous improvement. Develop measures of a transformed practice – efficiency and outcome quality – with internal feedback loops that include use of EMR reports to track progress.
• Oversee the bi-annual safety-net provider Quality Assurance Review (performed by external consultants).
• Assist providers in achieving EMR (eCW) meaningful use. Provide ongoing technical training and first tier support to the providers using the enterprise eCW platform.
• Assist providers in moving towards empaneling patients uploading patient panel for CRISP & access CRISP Encounter Notification Service.
• Lead periodic Clinic Manager Meetings, and convene or attend Executive Director Meetings as appropriate.

Contract Management

• Provide guidance on reimbursement structures that reward health outcomes.
• Create opportunity to introduce new payment methods to the primary care network that prepare these providers for future pay-for-outcome models expected from the Medicaid MCOs.

SECONDARY RESPONSIBILITIES

• Represent Montgomery Cares Program within PCC and the community as assigned.
• Participate on PCC workgroups of interest or as assigned.
• Assist with proposal development and program design for future grants and projects.
• Other duties as need or as assigned.

EDUCATION AND EXPERIENCE

• Bachelor’s Degree in Public Health, Healthcare Administration, Business Administration, Public Policy or related field required. Master’s degree preferred.
• Experienced team leader, with commitment to mentoring and growing staff.
• Minimum of 8 years of management experience in roles with both internal operations and external facing responsibilities. Experience in project management, organizing and coordinating projects/programs; identifying contract requirements and ensuring compliance; planning, arranging, and participating in meetings; monitoring and managing for results.
• Experience in a medical practice with an EMR desirable.
• Must have demonstrable experience in at least two of the following areas: network development, revenue cycle management, business process/performance improvement, clinical quality improvement, and or facilitation of learning collaboratives/learning action networks.

SKILLS AND ABILITIES

• Strong oral and written communication skills. Comfort with public presentation and speaking.
• Ability to build collaborative relationships at all organizational levels. Effective at building a cohesive team environment both for direct reports and with others teams.
• Problem solving techniques and processes to pro-actively identify potential issues and provide options for resolution.
• Ability to work independently.
• Project Management. Strong organizing skills with attention to detail.
• Critical thinking strategies to review data, present ideas, and information. Ability to analyze and summarize data to provide the data ‘story’ not just the numbers.
• Intermediate proficiency in Microsoft products (Excel, Word, Power Point). Familiarity with Microsoft Access or relational database reporting products useful.
• Ability and interest to learn new computer applications and systems.
• Sense of humor and politically perceptive.

ADA REQUIREMENTS

This job operates in a professional office environment. The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

· This role routinely uses standard office equipment such as computers, telephones, photocopiers, filing cabinets and fax machines.
· This is largely a sedentary role; however, some filing may be required.
· This would require the ability to lift files, open filing cabinets and bend or stand as necessary.
· Advanced math skills needed to calculate compensation, bonuses, benefits analysis, percentages, etc.
· Requires ability to learn new software applications as necessary.
· Must be able to lift up to 20 pounds.
· May require occasional travel.

DISCLAIMER

This job description indicates in general the nature and levels of work, knowledge, skills, abilities and other essential functions (as covered under the Americans with Disabilities Act) expected of an incumbent. It is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities required of an incumbent. An incumbent may be asked to perform other duties as required.