Provider Network Manager
Who we are
Cityblock Health is a new type of healthcare company, operating out of Brooklyn and backed by Alphabet’s Sidewalk Labs, along with some of the top healthcare investors in the country.
Our mission is to radically improve the health of urban communities, one block at a time. Importantly, our solutions are designed specifically for Medicaid and lower-income Medicare beneficiaries, and we bring the capability to deliver care in the home and neighborhood with our field-based teams.
In close collaboration with community based organizations and a leading commercial partner, we are reorganizing the health system to focus on what matters to our members. We deliver personalized primary care, behavioral health, and social services through a network of neighborhood hubs with deep community-based partnerships and world-class technology.
We partner with payers and at-risk providers, taking capitated financial risk to care for their most vulnerable, high and rising risk members. Additionally, we invest in strategic partnerships with community-based and social services organizations, in some instances bringing them into the value equation through sub-capitation and performance-based compensation.
Over the next year, we’ll continue to grow quickly, including entering new markets, each with their own commercial relationships and field-based teams. This role will be a key contributor to the success of our business.
We are seeking a collaborative Provider Network Manager to advance Cityblock’s social care model in New York. You will build relationships, process flows, and engage with In-network providers that contribute to the success of Cityblock’s market performance in New York.
- Be responsible for building and maintaining collaborative relationships with community physicians and other provider partners that collaborate with Cityblock Health to deliver excellent health outcomes and quality for our shared members
- Develop community PCP and BH clinician facing materials that explain the Cityblock model and our collaboration philosophy
- Develop an engagement plan including timelines and success metrics for community based PCPs and BH clinicians and roll-out the engagement strategy
- Develop and oversee the process of sending member care plans and EMR notes to PCPs
- Build relationships, process flows and initial approach to Identifying and engaging with In-network and high value providers to include: primary care physicians, specialists, home health, DME, Acute Care and Subacute care facilities.
- Identify high volume, potentially high value specialist, acute care and sub-acute care facilities, and then engage leaders within those organizations in the Cityblock model and processes
- In partnership with the analytics and medical economics team, to develop analyses and reporting that supports local network decision making and referral patterns
- Support relationship building and manage process optimization between Cityblock Health and other clinical health plan clinical partners in market (e.g.,DM/CM/UM vendors)
- Document current state, assist in developing future state and assist in implementing and tracking it
- Identify and track key metrics and present at joint operation committee meetings
- Facilitate ongoing relationships and meetings between organizations
- Identify key areas for improvement based on community PCP and behavioral health clinician input. Adjust workflows to improve these areas; assist with implementing & measuring changes.
- Develop and support referral management functions and processes.
- Develop and manage dashboard and metrics for referrals, medical trends, cost drivers and cost saving opportunities.
- MBA or MHA, or equivalent experience
- Experience working in a managed care organization, specifically in a provider network strategy and management function
- Excellent presentation, verbal and written communication skills
- Experience building mutually beneficial relationships with large providers groups and facilities
- Knowledge of Medicaid managed care and/or Medicare Advantage plans, and relevant federal and state legislation.
Nice to have:
- Experience in managed care clinical operations, risk adjustment, and/or medical cost analysis
- Working knowledge of New York provider networks and health systems
Cityblock values diversity as a core tenet of the work we do and 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.