What are the responsibilities and job description for the Manager, ACO Provider Transformation position at Cano Health?
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Job Summary
The Provider Transformation Manager will play a pivotal role in driving operational excellence and quality improvements in healthcare settings. This position requires a licensed Registered Nurse (RN) with substantial experience in managing operational and quality management Key Performance Indicators (KPIs). The specialist will lead initiatives aimed at transforming care delivery, optimizing provider workflows, and ensuring alignment with organizational goals to enhance patient outcomes and operational efficiency.
Essential Duties & Responsibilities
- Care Delivery Transformation: Collaborate with our healthcare providers to redesign and optimize clinical workflows, ensuring efficiency, patient safety, and quality of care. Collaboration would include Primary Care Providers, and Preferred Providers, including Skilled Nursing Facilities
- Operational Oversight: Oversee the management of operational KPIs such as patient throughput, resource utilization, staffing levels, and compliance with healthcare regulations.
- Quality Management: Lead quality improvement initiatives by monitoring and managing quality KPIs, including patient satisfaction, clinical outcomes, and adherence to evidence-based care guidelines.
- Data Analysis and Reporting: Analyze performance data related to operational and quality metrics, identify trends, and provide actionable insights to leadership and care teams.
- Stakeholder Collaboration: Work closely with interdisciplinary teams, including physicians, nurses, and administrative staff, to align provider transformation efforts with the organization's strategic objectives.
- Education and Training: Educate and train providers and staff on new policies, processes, and best practices to foster a culture of continuous improvement with a focus on Transitional Care Management and Chronic Care Management programs
- Change Management: Lead change management efforts by supporting the implementation of new clinical processes and technologies, facilitating provider adoption, and ensuring smooth transitions.
- Regulatory Compliance: Ensure compliance with healthcare regulations, standards, and accreditation requirements, particularly in relation to quality management and patient care.
- Project Management: Manage transformation projects from initiation to completion, coordinating resources, timelines, and deliverables to achieve desired outcomes.
Critical Results
- Increases in ACO-wide Transitional Care Management and Reductions in Hospital Readmission rate
- Increases in ACO-wide Physician Chronic Care Management rate
- Reductions in SNF LOS and SNF readmission rates
Best Practices
- Utilize data to guide transformation initiatives and decision-making processes. Regularly track and analyze operational and quality management KPIs, such as patient outcomes, workflow efficiency, and provider performance.
- Engage key stakeholders, including physicians, nurses, administrative staff, and leadership, throughout the transformation process. Foster a culture of collaboration by involving these stakeholders in planning and decision-making.
- Facilitate open communication, provide clear expectations, and offer training and support during the implementation of new workflows, policies, or technologies. Encourage feedback and participation to ensure smoother transitions and higher adoption rates.
- Embrace a mindset of continuous quality improvement (CQI) by regularly evaluating the effectiveness of transformation efforts and making iterative adjustments. Implement quality improvement methodologies such as Lean or Six Sigma to streamline processes, reduce waste, and enhance patient care.
- Keep up with evidence-based best practices in healthcare, and ensure that the changes being implemented are aligned with the latest clinical guidelines and regulatory requirements.
- Document improvements and celebrate successes to build momentum for ongoing transformation efforts.
Education & Experience
- Registered Nurse (RN) License: Must hold a current and active RN license.
- Experience: Minimum of 3 years of experience in a healthcare setting, with a focus on managing operational and quality management KPIs. Experience in Medicare Fee-For-Service Value Based Programs preferred (CMS MSSP, ACO Reach programs)
- Leadership: Demonstrated experience leading quality improvement initiatives and driving operational change in healthcare environments.
Education Requirements
Required/Preferred
Education Level
Discipline
Required
Undergraduate Degree
Preferred
Masters Degree
Nursing, Healthcare Administration, or a related field.
Knowledge, Skills & Proficiencies
- Data-Driven Mindset: Strong analytical skills with the ability to interpret complex data sets and utilize data to inform decision-making.
- Communication Skills: Excellent verbal and written communication skills, with the ability to effectively engage and influence stakeholders at all levels of the organization.
- Problem-Solving: Strong critical thinking and problem-solving skills, with a proactive approach to identifying and addressing operational and quality-related challenges.
- Project Management: Proven ability to manage multiple projects simultaneously, prioritize tasks, and meet deadlines.
- Tech Savvy: Proficiency with electronic health record (EHR) systems, healthcare analytics tools, and Microsoft Office Suite (Word, Excel, PowerPoint).
- Knowledge of Healthcare Regulations: In-depth understanding of healthcare regulations, including Joint Commission standards, CMS guidelines, and state-specific requirements.
- Experience with Lean, Six Sigma, or other performance improvement methodologies.
- Master's degree in Nursing, Healthcare Administration, or a related field.
- Certification in Healthcare Quality (CPHQ) or related accreditation.
Physical Requirements
This position works under usual office conditions. The employee is required to work at a personal computer as well as be on the phone for extended periods of time. Must be able to stand, sit, walk and occasionally climb. The incumbent must be able to work extended and flexible hours and weekends as needed. Physical demands include ability to lift up to 50 lbs. The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of the job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
Work Conditions
Must be able to perform essential functions such as typing, standing, sitting, stooping, and occasionally climbing
Travel Requirements (open text)
Job Position is primarily remote. ACH corporate offices are located in Miami, Florida, and staff living in the tri-county area are expected to come into our offices on a weekly basis. Minimal travel requirements for staff living outside of South Florida.
Travel Requirements
Amount of Expected Travel
Details
Yes
0-25%
Work might involve some driving/traveling to medical centers.
Tools & Equipment Used
Computer and peripherals, standard and customized software applications and tools, and usual office equipment.
Disclaimer
The duties and responsibilities described above are designed to indicate the general nature and level of work performed by associates within this classification. It is not designed to contain, or be interpreted as a comprehensive inventory of all duties, responsibilities, and qualifications required of associates assigned to this job. This is not an all-inclusive job description; therefore, management has the right to assign or reassign schedules, duties, and responsibilities to this job at any time. Cano Health is an equal opportunity/affirmative action employer. All qualified applicants will receive consideration for employment without regard to sex, gender identity, sexual orientation, race, color, religion, national origin, disability, protected veteran status, age, or any other characteristic protected by law.
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