Operations Specialist, Health Systems Integration

Title: Operations Specialist, Health Systems Integration (25048)

Location: Portland United States

Job Description:

Requisition #

25048

Exemption Status

Exempt

Management Level

Staff

Direct Reports

n/a

Manager Title

Manager, Operations, Health System Integration

Posting Notes

This is a  hybrid position that will require you to go into the downtown Portland office 1-2 days a month.

 

Job Summary

The Operations Specialist for Health Systems Integration supports and promotes alignment of initiatives implemented by health plan and delivery system partners with Health Share’s strategic priorities and regulatory requirements. Reporting to the Manager of Operations, this position leverages working relationships with delivery system partners and providers across the network, as well as other Coordinated Care Organizations (CCO) and the Oregon Health Authority (OHA). The Operations Specialist also works with key Health Share of Oregon staff in the areas of policy management, deliverable management, project coordination, provider network management, dashboard maintenance, and compliance.

 

Essential Responsibilities

Relationship Management:

• Administers and maintains a portfolio of operational policies, priorities, programs, and activities between Health Share and integrated delivery system/integrated community network partners to support oversight, monitoring, and compliance.  
• Plans and organizes regular stakeholder meetings to ensure alignment, distinguishes issues to be resolved, and proactively identifies additional opportunities for collaboration to improve Health Share performance and member experience.
• Develops appropriate work plans and conducts project coordination or management as needed.
• Collaborates with others within Health Share, in particular with the Compliance team, to coordinate timely compliance with OHA requirements between multiple external partners.

Communication:

• Collects, prioritizes, tracks and responds to requests for information from integrated delivery system/integrated community network staff and stakeholders.
• Fosters communication, knowledge sharing, and effective issue resolution throughout Health Share’s internal teams and across partner organizations.
• Supports the infrastructure and communication systems of Member Advisory Committees (MACs) and leads committees and workgroups, working proactively with key stakeholders to develop agendas and action plans to meet identified goals and objectives.
• Develops and implements communication tactics to ensure all stakeholders are informed on a consistent basis.
• Ensures proper documentation and storage of meeting notes, minutes, agendas, and materials.
• Oversees completion of monthly committee communications to inform Advisory and Board Committees.

 

Operational Planning and Monitoring

• Serves as a Subject Matter Expert on required deliverables for the Health Systems Integration team, including past submission performance, active findings, and remediation activities, including but not limited to Administrative Rules (OARs) relating to Network Adequacy, Provider Directory requirements, other health plan operations relating to Health Systems Integration.
• Plans, coordinates, and monitors compliance of certain Health Share network adequacy requirements and artifacts, including Delivery System Network (DSN) deliverable and evaluation results.
• Recommends and establishes standards and processes for Workgroups to align strategies and goals across Health Share’s governance structure. 
• Provides analysis to inform policies and procedures required for the organization to execute contractual responsibilities.
• Ensures Health Share-convened Workgroups are achieving goals as articulated in their charters are escalating issues as appropriate to Member Advisory Committees.
• Collaborate with Information Systems (IS) partners to maintain and evolve the Provider Network Insights dashboard.
• Proposes and implements process improvements.
• Applies critical thinking to propose and follow-through on problem-solving.
• Works with plan partners to ensure required reports are received in correct formats by communicated deadlines.
• Maintains agreed-upon work schedule.
• Demonstrates cooperation and teamwork.
• Provides cross-training on specific job responsibilities.
• Meets identified business goals that contribute to departmental goals.

 

Organizational Responsibilities

• Perform work in alignment with the organization’s mission, vision and values.
• Support the organization’s commitment to equity, diversity and inclusion by fostering a culture of open mindedness, cultural awareness, compassion and respect for all individuals.
• Strive to meet annual business goals in support the organization’s strategic goals.
• Adhere to the organization’s policies, procedures and other relevant compliance needs.
• Perform other duties as needed.

 

Knowledge, Skills and Abilities Required

Knowledge:

• Robust understanding of the division of authority, responsibilities, and rights in the Oregon Medicaid landscape between regulatory bodies, delivery systems, health plans, and members
• Understanding of delivery system and health plan operations
• Understanding of Health Share, including its vision/mission, relationships with partner organizations

Core Skills and Abilities:

• Ability to nurture and leverage professional relationships with integrated delivery system/integrated community network plan partners and Health Share colleagues
• Demonstrated ability to achieve desired outcomes through creativity and innovative approaches to problem-solving
• Ability to oversee and monitor contracted initiatives/requirements
• Excellent interpersonal skills and ability to interact professionally with culturally and educationally diverse staff
• Ability to demonstrate flexibility and adaptability when faced with internal or external barriers, or when faced with differing points of view
• Strong planning and project coordination skills, including ability to effectively support meeting facilitation
• Ability to communicate effectively verbally and in writing, including report/memo writing for a variety of audiences
• Ability to anticipate next steps, be proactive and collaborate with coworkers and stakeholders
• Ability to maintain accurate and organized records
• Ability to assemble, edit and summarize material, information and data
• Working knowledge of and the ability to apply applicable federal, state and local laws, rules regulations and policies related to the Medicaid landscape in Oregon
• Ability to be self-directed and work independently with minimal supervision as needed
• Ability to proactively identify project risks and formulate plans to effectively mitigate them
• Skilled at managing expectations, tracking contracted deliverables, and plan partner performance
• Ability to develop roadmaps, work plans, prioritize tasks, and meet objectives
• Ability to see, read, and perform repetitive finger and wrist movement with a computer for at least 6 hours/day
• Ability to hear and speak clearly for at least 3-6 hours/day
• Ability to learn, focus, understand, and evaluate information and determine appropriate actions
• Proficient in Microsoft Office Suite and Outlook

 

Education and/or Experience

Required:

• Minimum 3 years’ increasingly responsible experience managing projects or initiatives in a health-related field
• Experience in building relationships with and defining solutions with a diverse group of stakeholders

Preferred:

• Experience managing projects or initiatives in a delivery system or health plan setting
• Project management training or certification such as LEAN, CAP or PMP
• Bachelor’s degree in Health Care Administration, Public Health, or related field