About Fallon Health:
Founded in 1977, Fallon Health is a leading health care services organization that supports the diverse and changing needs of those we serve. In addition to offering innovative health insurance solutions and a variety of Medicaid and Medicare products, we excel in creating unique health care programs and services that provide coordinated, integrated care for seniors and individuals with complex health needs. Fallon has consistently ranked among the nation’s top health plans, and is the only health plan in Massachusetts to have been awarded “Excellent” Accreditation by the National Committee for Quality Assurance for its HMO, Medicare Advantage and Medicaid products. For more information, visit www.fallonhealth.org.
Brief summary of purpose:
The ACO Clinical Project Manager will develop, implement, and manage clinical-focused projects for the Medicaid ACO, both internally within FH and externally with our ACO partners, to manage cost of care and patient outcomes for the Medicaid ACO program. The ACO Clinical Project Manager works closely with the FH Medicaid ACO Medical Director, as well as the Fallon Health (FH) VP of Quality and Population Health and other members of the Medicaid ACO team, and ACO partners to manage and monitor specific clinical initiatives.
Demonstrate the following areas of proficiency including, but not limited to:
Bachelors or advanced degree in nursing or health care related field. Masters degree preferred (Nursing, MBA, MPH, etc.) OR graduate of a social worker program with a Masters degree in social work or psychology.
License: Active licensure as a Registered Nurse (RN) in Massachusetts OR Licensed Clinical Social Worker (LCSW) OR Licensed Independent Clinical Social Worker (LICSW) in Massachusetts
Other: Satisfactory Criminal Offender Record Information (CORI) results
Resources (systems, etc.) used in performing role
Microsoft Office products including but not limited to: Excel, PowerPoint, Word, Outlook, Visio, reporting software such as Business Objects, Boxer Application, QNXT, TruCare, and other applications
Physical Requirements of Role
Physical health sufficient to meet the ergonomic standards and demands of the position and the ability to transport self to member, provider, facility sites and locations. Valid Driver’s License and Clean Driving Record Required and a vehicle to be used for in-state travel.