Director Patient Experience
Emergent Holdings

This position is responsible for all Senior Health Services (SHS) patient experience engagement programs across Blue Cross Blue Shield of Michigan and Blue Care Network. The Director Patient Experience reports to the Managing Director of Member and Patient Experience and is responsible for building patient satisfaction and engagement interventions and programs that align across the provider delivery system in supporting patient care.

RESPONSIBILITIES/TASKS:

• Set the strategic direction for Senior Health Services as it relates to the experience members have when finding and getting care
• Serve as a key leader in all member experience initiatives impacting the provider related measures of Medicare CAHPS and HOS performance standards related to Medicare Star ratings
• Understand competitive and market dynamics and best practices to ensure ongoing improvement in the patient experience and provider-related CAHPS/HOS measures.M3B
• Review CAHPS Data, KPIs, and monthly performance dashboards to identify trends in performance data and opportunities for improvement
• Set Intervention reporting cadences and develop ROI and performance standards for new and existing intervention programs
• Lead a team of patient experience and CAHPS experts to establish and drive multi-year improvement plans for seniors as they interact with Blue Cross and our providers
• Understand and develop plans to improve member patterns of care, especially from a volume perspective, provider report cards both internal and external, provider access, provider changes, members complaints and a grievances, disenrollment, denials of concurrent and retrospective care based on medical necessity or administrative issues and appeal requests initiated by providers, facilities and members.
• Work with medical informatics and Stars team to design quarterly reports on providers with significant volume from the highest to the lowest levels of satisfaction. This position is responsible for educating providers around workflow process improvements, and champion member satisfaction initiatives both internally for BCBSM and working with our Health Care Value organization to ensure there is education and new interventions and VBP arrangements tied to CAHPS scores.
• Lead service workgroups across the organization that create a holistic and blended approach to improvement of patient experience
• Work across Health Care Value to design and develop provider programs and outreach that directly impact the patient experience
• Serve as a key member within SHS performance office and other SHS leadership forums
• Other duties may be assigned based on designated department assignment.

DIRECTION EXERCISED:

Directly supervises exempt staff in accordance with company policies and applicable Federal and State Laws. Responsibilities include, but are not limited to, effectively interviewing, hiring, terminating, and training employees; planning, assigning, and directing work; appraising performance; rewarding and counseling employees; addressing complaints and resolving problems; supporting and encouraging the engagement process.

This position description identifies the responsibilities and tasks typically associated with the performance of the position. Other relevant essential functions may be required.

EMPLOYMENT QUALIFICATIONS:

EDUCATION:

Bachelor's degree in a related field. Master's degree in a related field preferred. Continuous learning, as defined by the Company's learning philosophy, is required. Certification or progress toward certification is highly preferred and encouraged.

EXPERIENCE:

Ten (10) years' experience in Quality and/or CAHPS improvement or Medicare Stars strategy work. Demonstrated experience delivering member and patient care programs. Five years management or supervisory experience in a related field required.

SKILLS/KNOWLEDGE/ABILITIES (SKA) REQUIRED:

• Industry leading Medicare Stars and CAHPS/HOS performance knowledge
• Understanding of patient experience programs and delivery of value-based care programs
• Quality and Consumer Advocacy skills and experience
• Proven leadership acumen and track-record of high performance delivering impactful solutions.
• Ability to analyze and distill large data sets and conduct root cause analysis
• Must demonstrate leadership ability and team building skills to effectively supervise professional and non-professional staff and interact with all levels of management.
• Ability to work with and empower others on a collaborative basis to ensure success of unit team.
• Ability to effectively exchange information, in verbal or written form, by sharing ideas, reporting facts and other information, responding to questions, and employing active listening techniques.
• Great computer skills preferred
• Other related skills and/or abilities may be required to perform this job.

WORKING CONDITIONS:

Work is performed in an office setting with no unusual hazards. Travel will be required.

The qualifications listed above are intended to represent the minimum education, experience, skills, knowledge and ability levels associated with performing the duties and responsibilities contained in this job description.

We are an Equal Opportunity Employer. Diversity is valued and we will not tolerate discrimination or harassment in any form. Candidates for the position stated above are hired on an \"at will\" basis. Nothing herein is intended to create a contract.

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