About Us:

Cityblock Health is the first tech-driven provider for communities with complex needs—bringing better care to where it’s needed most, block by block. Founded in 2017 on the premise that “health is local” and based in Brooklyn, we are backed by Alphabet’s Sidewalk Labs along with some of the top healthcare investors in the country.

Our mission is to improve the health of underserved communities. Importantly, our solutions are designed specifically for Medicaid and lower-income Medicare beneficiaries, and we meet our members where they are, bringing care into the home and neighborhoods through our community-based care teams and Virtual Care offerings.

In close collaboration with community-based organizations, local providers, and leading health plans, we are reorganizing the health system to focus on what matters to our members. Equipped with world-class, custom care delivery technology, we deliver personalized primary care, behavioral health, and social services to deliver a radically better experience of care for every member and community we serve.

Over the next year, we’ll grow quickly to bring better care to many more members and their communities. To do this, we need people who, like us, believe that everyone should have good care for what matters to them, in their community. 

Our work is grounded in a belief in the power of a diverse community. To close gaps in care and advance equity in the communities we serve, we have to start with making our own team diverse and inclusive. Our ways of working are characterized by creativity, collaboration, and mutual learning that comes from bringing together a community from diverse backgrounds and perspectives. We strive to ensure that every person on the Cityblock team, and every Cityblock member, feels supported and included as a part of our community.

Our Values:

• Aim for Understanding
• Be All In
• Bring Your Whole Self
• Lean Into Discomfort
• Put Members First

About the Role: 

As the Director of MSO Operations, you will be accountable for developing and overseeing the core systems and market strategy around key quality measures to ensure Cityblock is meeting contractual requirements and performance targets. You will also lead Cityblock’s care management delegation program as the business owner overseeing success of the delegation arrangements with each of our health plan partners. In addition, the role will be responsible for the oversight of our credentialing program for the organization. This role will also oversee the future development of other potential emerging Value Services functions, including strategy, implementation and oversight. 

You will: 

• Partner in new partner/ existing partner contracting phase to set reasonable/stretch targets for Quality Metrics by determining NCQA current %tile and target %tiles; quality gating rules; and translation to data requirements
• Accountable for delivery of key strategies, plans, and improvement initiatives for HEDIS, Medicare Stars requirements, and other clinical quality measurements to include: data pursuit strategy, barrier analysis, interventions for rate improvement and monitoring & evaluation
• Responsible for partnership with the health plan teams in each market on data transfer for quality measures, chart audits, and monthly reporting standards
• Responsible for Quality initiative campaigns in partnership with Brand/Marketing teams 
• Responsible for interpreting contract standards and applying to data/analytics reporting that filter to the market level
• Partner with the data and engineering teams to create meaningful reporting mechanisms for real time use for closing member quality opportunities
• Create a crosswalk for roles and responsibilities related to Care Management Delegation activities for each existing and new contract, ensuring responsibilities between parties are well defined
• Draft and oversee SLAs for each contract, maintaining appropriate databases of policies, procedures and processes for oversight
• Participates and guides the health plan team on their oversight/guidance of the audit process for CBH
• Oversee the care management life-cycle from the pre-delegation assessment to on-going management and reviews/audits by our health plan partners
• Requests data/product innovations for specific contractual needs or ongoing division/department improvements
• Work cross-functionally across our Clinical, Data and Product teams ensuring a reliable regulatory performance across each of our partners
• Serve as the primary point of contact for our partner Delegation Oversight Committees and leads, ensuring key requirements are met, corrective action plans are completed, and new requirements are implemented within our care model
• Partner with market operations teams on strategies to improve care management performance when gaps are identified
• Responsible for timely credentialing and delegated credentialing of associated providers, partnering closely with the people, market and health plan teams
• Responsible for building the playbook for other potential emerging Value Services functions and determining appropriate buy/build strategies along with key leadership team members 
• Directly oversee and manage individual contributors and managers, holding teams accountable; works cross functionally with market teams on shared responsibilities 

Requirements for the Role: 

• You have at least 8+ years of experience with demonstrated results as the leader of medical management, quality, care management, or related health plan operations functions.  Experience with NCQA Care Management accreditation requirements preferred.  
• You have previously led development, implementation, and operations of successful quality management and or care management operations functions
• You have experience building a robust performance monitoring structure around quality and care management, ideally in a high growth technology company
• You are outcomes-focused and data driven, with an ability to bring best practices and strategies to bear quickly in overseeing the team to drive timely results 
• You are an intuitive navigator of team and interpersonal dynamics, skilled at exerting direct and indirect influence in order to get things done 
• You have excellent communication skills and a strong editorial mindset towards clean and crisp messaging. You can modulate content and medium thoughtfully for audience scale and seniority. 
• You are a strong people manager that can appropriately balance effective delivery on goals as well as strong professional development for direct reports and their teams.  
• You are a self aware leader and team member interested in feedback and growth.
• You are aligned to the Cityblock mission and dedicated to build a diverse, equitable, and inclusive team. 

How We Define Success:

• You have a high functioning quality program in place, achieving contractual targets and maintaining a 4 star rating or above with health plan partners
• Maintenance of care management delegation, with high score on audits and meeting core performance metrics
• Maintenance of credentialing, achieving both internal and external guidelines and performance targets
• Development of comprehensive playbook for other potential emerging Value Services functions, including  utilization management is in place, positioning us to have influence over key levers to drive total cost of care savings

What We’d Like From You:

• A resume and/or LinkedIn profile 
• A short cover letter, please!

Cityblock values diversity as a core tenet of the work we do and the populations we serve. We are an equal opportunity employer, indiscriminate of race, religion, ethnicity, national origin, citizenship, gender, gender identity, sexual orientation, age, veteran status, disability, genetic information, or any other protected characteristic.

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We do not accept unsolicited resumes from outside recruiters/placement agencies. Cityblock will not pay fees associated with resumes presented through unsolicited means.