Fallon Health

Manager

• Provides culturally appropriate care coordination
• Develops member centered care plans by identifying member care needs
• Monitors progression of member goals and care plan goals
• Collaborates with care team members
• Actively participates in internal clinical rounds and huddles
• Assists with care coordination with community Partners

Social Work Care Manager

Account Manager

• Develop and institutionalize operational metrics
• Research, collection, tracking and reporting of vendor metrics
• Develop and maintain vendor scorecard to be reviewed with vendor and internal departments and stakeholders
• Conduct vendor delegation audits and meetings to review vendor performance linked to regulatory compliance and contractual obligation
• Main point of contact for vendor and internal departments: Track escalated issues and reporting of root cause analysis
• Troubleshoot all vendor problems and present to management as required
• Identify and implement continuous enhancements and efficiencies associated with vendor management
• Perform regulatory compliance and performance of Fallon’s vendors
• Maintain vendor information and share with internal team related to contract obligations and day-to-day updates

RN Vendor Relations Manager

• Member Assessment & Education: Telephonic and in-home assessments; create individualized care plans with members and care teams.
• Care Coordination & Collaboration: Develop member-centered care plans and monitor progress toward goals.
• Provider & Regulatory Responsibilities: Attend care plan meetings and provider visits, lead reviews when applicable.
• Other: Support quality initiatives and department projects. Cover assignments as needed and perform other duties as directed.

Social Work Care Manager

RN Vendor Relations Manager

Behavioral Health Case Manager