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Interested applicants for either position please email cover letter and resume to C3 for consideration.
Job Title: Director, Social Determinants of Health and Long-Term Services and Supports
Reports to: Senior Director, Behavioral Health
Job description revision number and date: 1.2; 11/13/17
The Director for Social Determinants of Health (SDOH) and Long-Term Services and Supports (LTSS) is responsible for developing, implementing and managing strategies for SDOH and LTSS through all aspects of C3’s model of care and the delivery system. The individual will work throughout the Company, with participating health centers, and with the MassHealth network of providers to facilitate efforts to achieve goals for quality care and total cost of care for our members with SDOH and LTSS needs. On an ongoing basis, s/he will assess the effectiveness of our model of care in addressing SDOH and LTSS needs and costs and make recommendations for process and program improvements and new programs to address. In addition, this role champions building a culture of disability competence and de-medicalization of care throughout C3 and participating health centers and partners. The Director of SDOH and LTSS reports to the Senior Director of Behavioral Health.
The Director of SDOH and LTSS is part of C3’s Office of Practice Transformation and Quality (PTQ). The goal of the Office of PTQ is to enable and support participating Federally Qualified Health Centers (FQHCs) to advance and sustain the Integrated Patient-Centered Medical Home (PCMH) model. We aim to achieve excellence in value-based, Accountable Care Organization (ACO) infrastructure, enhance quality of care, and to bend the cost curve and support the long-term sustainability of the MassHealth program. We strive to exceed C3’s cost and quality goals in all ventures.
Specific responsibilities include:
- Oversight of Long Term Services and Supports Community Partners (LTSS CPs)
- Developing and implementing a strategy and model contract to contract with LTSS CPs as designated by MassHealth in order to comply with state requirements while also supporting the Company’s overall goals for quality, TCOC, and integrated care management
- Working with COO, Senior Director of Clinical Operations, and Director of IT to develop workflows for referrals, joint care management, reporting, and other interfaces and operations with contracted LTSS CPs
- Monitoring contract performance and compliance by contracted LTSS CPs, and creating improvement plans when issues arise
- Ensure that IT platforms are configured to meet LTSS CP reporting requirements
- Working in collaboration with the Chief of Practice Transformation and Quality, the Chief Medical Officer, and the Chief Behavioral Health Officer, design and implement Company programs to address social determinants of health as part of the patient centered medical home at C3 health centers. This work includes:
- Developing annual goals for SDOHs as part of the practice transformation goals for the health centers
- Finding and developing proposals for potential funding sources to enhance capability to address SDOHs
- Acting as the business lead in the development and implementation of Healthify resource directory and its integration into the Identifi care management platform and on-going improvement
- Facilitating the development of work processes and training on screening and addressing SDOHs to be customized by participating health centers.
- Developing procedures, processes and services for flexible spending as it comes on line as part of MassHealth contract
- Monitoring results of SDOH program and make recommendations for improvements going forward.
- Participate in development of strategies, implementation, and quality improvement to meet MassHealth quality measures and ensure contract compliance as they relate to long term services and supports and social determinants of health
- Ensure disability access and ensure a culture of disability competence and de-medicalization in the model of care
- Ensure the Company and participating health centers meet the requirements for disability access required by MassHealth contract
- Ensure training of new employees at health centers, C3, and C3 material subcontractors meets the requirements for disability competence and an understanding of LTSS services and supports and SDOHs as required in contract with MassHealth
- Through ongoing training, communications, and other creative vehicles, ensure the Company and its participating health centers foster a culture that reflects disability competence and trauma-informed care and a whole person perspective
- Ensure that use of LTSS services by participating providers contributes to the goals of quality and TCOC
- Assist in the determination of annual corporate strategic priorities for the continued evolution of the PCMH platform from the perspective of the LTSS needs of C3 participants
- Utilize both qualitative data from on-the-ground interactions with health centers and qualitative data from the Company’s analytics platform to identify, prioritize, and design process improvement initiatives in LTSS, including use of home health services, within C3 health centers
- Provide strategic and content input to transitions of care and complex care management programs to ensure they are successful in addressing enrollees with LTSS needs
- Lead the development of relationships with inpatient LTSS facilities to further the Company’s cost and quality goals
- Advocate for and develop strategies for the LTSS services when they become part of TCOC in future years
- Maintain relationship and work with MassHealth’s LTSS vendor/TPA to advocate for adequacy of the MassHealth LTSS network of services
- Monitor analytics and performance by external inpatient and outpatient LTSS providers and develop and implement a strategy for preferred relationships and contracts, as needed
Required Skills and Experience
- Masters level degree education or equivalent experience
- Experience in leadership and development of new programs
- Thorough knowledge of the role of social determinants in health and of policies and programs to mitigate the adverse impact of social determinants on health
- Thorough knowledge of the full landscape of LTSS services and providers and experience working with LTSS providers and community agencies
- Experience with integrated models of care involving SDOH and LTSS
- Strong interpersonal skills and negotiating skills
- Ability to work collaboratively, across the organization, and as part of a team
- Willingness to “roll up sleeves” in a start-up environment
- Excellent project management skills and attention to detail.
- Ability to juggle multiple priorities in a fast-paced start-up environment.
- A strong commitment to the organization’s mission.
- Ability to communicate dexterously across a diverse range of stakeholders, from executive management (CEOs, CMOs, CFOs, COOs), to primary care and support staff responsible for driving the success of strategic programs on the ground
Job Title: Finance Analyst
Reports to: Chief Finance Officer (CFO)
Classification: Individual Contributor
Job description revision number and date: 1.0, 10/25/17
The Finance Analyst works closely with the Chief Financial Officer (CFO) to ensure the Company’s finance operations, financial reporting, and financial analysis are efficient, accurate, and insightful. The Finance Analyst works collaboratively with all internal departments and with the Company’s Federally Qualified Health Centers (FQHC) to support the vision, mission and goals of the organization.
The responsibilities of the Finance Analyst including the following work across four domains:
- Ensure that timesheets, time off, and other payroll inputs are accurate
- Prepare vendor invoices for approval and payment, and ensure that payments are appropriately documented in the files
- Ensure expenses are classified in the accounting system appropriately
- Implement and manage banking controls, such as positive pay
- Support annual audit process
- Periodically, develops and/or revises finance policies and procedures
- Through formal and informal education and training, ensures that employees are adhering to Finance policies and procedures
- Support sound financial operations and minimize risk by consistently seeking ways to enhance the integrity and strength of the Company’s financial operations
- Support development and execution of annual budget process, monthly reporting, and periodic re-forecasting
- Prepare financial reporting for the Company’s contracts and grants, including obligations under DSRIP (Delivery System Reform Implementation Payments) and work with material subcontractor and FQHCs, who are sub-grantees for the purposes of DSRIP
- Prepare periodic reporting for regulatory authorities and state agencies such as the Division of Insurance, Health Policy Commission, and Secretary of State
- Prepare reporting and analysis on core business operations, quality, and claims performance drivers, preparing standard and ad hoc reporting for senior management, Board of Directors, and FQHC leadership
- Use financial reports produced by external partners to inform CFO and management of areas of concern and/or areas that need financial performance improvement
- Support development and execution of the organization’s medical economics process, analyzing and assessing performance to separate random variation from true directional data, to understand potential causes, and to develop and measure the value of potential interventions
- Provide analytic support for financial measures on the Company’s strategic plan; this support may include working with colleagues to devise strategies to effectively assess the performance of strategic initiatives
- Support development of monthly presentations to the Audit Committee and the Finance Committee of the Board of Directors, including monthly financial statements
Other duties and projects as assigned.
- He/she must possess strong analytical skills, be flexible and a team player, have a customer-service mentality, and communicate clearly and succinctly in writing and verbally.
- Bachelor’s Degree required; degree in Accounting, Finance, Business Administration or related field preferred but not required
- Graduate degree in a finance-related field is preferred, but not required
- At least two years successful experience in public accounting, audit, or tax firm; or consulting experience focusing substantially on financial planning and analysis
- Self-starter; exercises high degree of initiative, judgement, discretion and decision making to achieve objectives
- Works well with others, understanding different perspectives and finding collaborative ways to the get the job done
- Comfortable multi-tasking
- Performs with great integrity and produces accurate work with close attention to detail, especially in the completion of final deliverables to internal and external stakeholders
Job Title: Member Advocate
Reports to: Director, Member Operations
Job description revision number and date: 1.0, 9/14/17
Community Care Cooperative (C3) seeks passionate, talented, and hard-working employees to help transform the health of underserved communities and directly contribute to improving the health and wellness of C3 members. C3 Member Advocates will serve C3 enrollees, helping them navigate the ACO and ensuring they understand their benefits, rights, and responsibilities.
Ideal candidates will deliver exceptional customer service, demonstrate empathy and strong communication skills, thrive in a productive, fast-paced environment, be comfortable fielding inbound calls on a wide range of topics, and placing outbound calls to engage enrollees in appropriate care and C3 programs. C3 is growing, and looking for team members who can adapt as the organization evolves. The successful candidate will be fluent in Spanish.
C3 is a new and innovative Accountable Care Organization (ACO), built around a group of Federally Qualified Health Centers (FQHCs) committed to providing coordinated, holistic, and culturally appropriate care in the communities where they live and work.
- Respond to member inquiries on a broad range of topics and in a variety of channels, primarily phone and including mail, email, and fax. Answer incoming telephone calls promptly, politely, and professionally.
- Appropriately access information, systems, and resources as needed to resolve enrollee or provider issues, ideally during initial contact. When necessary, triage to or connect with resources such as the language line, care management, MassHealth, or other entities.
- Provide education and assistance to members on ACO policies and procedures and enrollee rights and responsibilities, including grievances and appeals. Follow C3 and MassHealth grievance and appeals processes.
- Receive, respond, and triage other types of callers, including provider offices, the general public, media outlets, or others and route appropriately to resolve inquiries. Follow C3 policies and procedures for handling each type of caller.
- Conduct outbound calls as needed for a range of purposes, including but not limited to completing Care Needs Screening, engaging members in C3 or related programs, and following up to resolve outstanding issues. Document outbound call statistics and disposition according to C3 policies and procedures for each initiative.
- Accurately and thoroughly document all communications in the appropriate systems, in accordance with C3 policies and procedures, to enable monitoring, tracking, reporting, and analysis of call volume, outbound call disposition, and other statistics. Assist in reporting of those statistics as needed. Follow established regulations and procedures in collection, recording, storage and handling of information.
- Consistently meet contractual and C3 standards and expectations for call center performance (volume, timeliness, quality of service).
- Collaborate with C3 staff and partners to effectively answer inquiries and resolve issues.
- Protect and preserve confidentiality of all enrollee and C3 information at all times in accordance with HIPAA requirements and C3 policies and procedures.
- Follow processes for fulfilling member requests for information, ID cards, or other materials. Process returned mail according to C3 policies and procedures.
- Represent the ACO in the community or at public forums as requested.
- Maintain high standards of professional conduct. Comply with the all applicable C3 policies and procedures, expectations, and standards. Attend required training.
- Perform other tasks, duties, or projects as assigned.
Education and Experience:
- Prior experience in a health care setting and knowledge of health centers, managed care organizations, and/or MassHealth strongly preferred
- Associates degree preferred
- At least one year of experience working in customer service role a plus
Knowledge, Skills, and Abilities:
- Fluency in English and Spanish (oral and written) is required
- Ability, orientation, and commitment to provide outstanding customer service
- Highly developed sense of integrity
- Ability to communicate clearly and professionally, both orally and in writing
- Ability to actively listen, demonstrate patients and empathy, and authentically engage with individuals in a caring and helpful manner
- Ability to identify and resolve problems and maintain composure and sound judgment in difficult or stressful situations
- Knowledge of and/or ability to learn and adhere to HIPAA rules, MassHealth contractual requirements, and other applicable regulations
- Ability to learn new systems and tools, including for tracking/recording of contacts
- Ability to manage multiple priorities in an effective and organized manner
- Strong attention to detail
- Capacity to navigate a computer while on the phone
- Experience with core Microsoft Office products (e.g., Outlook)
Additional job opportunities will be posted soon; check back or email for more information.