Senior Associate, Care Management - Delegation at Cityblock Health
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.
- Aim for Understanding
- Be All In
- Bring Your Whole Self
- Lean Into Discomfort
- Put Members First
About the Role:
We are seeking a talented Senior Associate, Care Management - Delegation to help manage delegation responsibilities as we scale. You'll work closely with our Care Team Leads, Quality teams, and Market Operations team, and health plan partners to manage our accreditation delegation function at Cityblock. This is an exceptional opportunity for a process-oriented, hungry self-starter who is interested in a cross-functional role at a rapidly scaling organization.
- Manage multiple audits and related projects, make judgements around objectives and scope, ensure effective and efficient audit execution.
- Monitor, analyze data reported, and identify non-compliance with regulatory requirements and issue corrective action plans (CAPs) as required.
- Develop, implement and manage corrective action plans (CAPs)/recommendations when deficiencies are identified and document follow-up to completion.
- Act as an operational expert and interventionist through communication, education and design of programs and strategies to assist delegated entities to meet regulatory and accrediting standards.
- Aggregate and analyze audit findings into a reportable format and report to appropriate departments.
- Evaluate and validate Care Management required reporting to ensure continued compliance with delegated responsibilities.
- Develop, prepare and analyze reports for management review and present to various levels of management and committees.
- Participate in Care Management/Clinical Committee meetings.
- Assist with planning and implementation of formal education sessions to Market Ops teams to address non-compliance issues.
- Collaborate with internal business units to support reporting requests and maintain reports.
- Works with the Delegation Oversight Manager to develop and maintain delegation audit calendar, tools, policies and reporting templates.
- Assist with preparation of documents for CMS and/or other regulatory audit audits as needed by our health plan partners.
- Develop and maintain policies and procedures.
- Other projects and duties as assigned.
Requirements for the Role:
- Bachelor's degree in Nursing, or Social Work, or Masters in Healthcare Administration strongly preferred; however, an equivalent combination of education and experience that provides proficiency in the areas of responsibility, may be substituted for the stated education and experience requirements.
- Minimum 2 year accreditation experience; NCQA, URAC, and/or CMS regulations.
- Strong knowledge of managed care principles and delivery systems, medical management process, accreditation and regulatory standards delegated oversight processes, and workflow systems.
- Knowledge of managed care compliance, CMS regulatory and NCQA standards.
- Strong ability to quickly build relationships and trust with our clinical and clinical ops teams.
- Strong understanding in Medicaid and Medicare requirements across multiple states.
How We Define Success:
- Self-starter and able to work independently.
- Knowledge of audit processes and applicable federal regulatory and accredited standards.
- Must possess a high level of organizational skills to maintain accurate records and documentation.
- Attention to detail with analytical and problem-solving capabilities.
- Ability to take initiative and see tasks to completion.
- Experience with Google suite of products
- Excellent verbal and written communication skills and able to maintain positive relations with internal and external partners at all levels.
- Maintain confidentiality and comply with Health Insurance Portability and Accountability Act (HIPAA).
- Ability to establish and maintain positive and effective work relationships with coworkers, clients, members, providers and customers.
Nice to Have, But Not Required:
- Prior experience working in a start-up setting.
- Prior experience working with Google products.
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.
We do not accept unsolicited resumes from outside recruiters/placement agencies. Cityblock will not pay fees associated with resumes presented through unsolicited means.