СШАDirector, Enhanced Care Management
4 дн. назад
145k–160k USD / годСШАDirectorRemote
Responsible for directing and overseeing operations of the enhanced care management program to improve health outcomes and lower costs.
Обязанности
- The Director of Enhanced Care Management is responsible for directing and overseeing operations of the enhanced care management program. This includes responsibility for Cal AIM program performance, provider and community collaboration/engagement, oversight of the care management specialists, policy development, process improvement/program enhancements, managing interdependencies and risks, and developing growth opportunities. The director works on projects from the point of conceptualization up to the implementation stages, and is responsible for resolving complex problems. The director supports the VP of Clinical Operations in the development of strategy that results in better health quality outcomes, better patient care, and lower cost of care.
- The Director of Enhanced Care Management will develop, implement, supervise, and manage ’s Enhanced Case Management Program. They will supervise Clinical Managers, Clinical Consultants and Lead Care Managers. This individual will be responsible for administering the ECM program, developing linkage with healthcare plans, outreach, creating clear and easy access and entry into the ECM program, program evaluation, and staff supervision.
- At this time we are only considering applicants in the following states: Arizona, California, Colorado, Illinois, Nevada, Oregon, Texas, Utah, and Washington.
- Refine and implement program policies and procedures
- Supervise Clinical Managers, Lead Care Managers, and Support Staff
- Oversee day to day ECM program
- Ensure that ECM contract goals and objectives are met
- Ensure contract regulatory and data requirements are met
- Ensure records (electronic and physical) and billing requirements are kept up to standards
- Oversee assessments, intakes, care planning, crisis management, transition plans
- Oversee and ensure staffing and staff training
- Run EHR reports as needed
- Oversees claims submission, denials, and receipt of payments
- Attends meetings and represents the organization with the public, local businesses, employers, health plans, vendors, regulatory and outside vendors
- Provides reports to management and managed care plans regarding ECM as needed
- Responsible for CalAIM program performance and successful execution of all SLAs.
- Oversee all aspects of running an efficient team, focusing on role definition and attainment of goals
- Design and implement standard operating procedures and workflows for the department
- Develop strategic messaging that conveys the company’s value proposition and overcomes patient objections
- Manage quality assurance programs to enhance the client experience
- Develop KPIs that align team member performance to business objectives
- Manage P&L and report accurate business results in monthly operations reviews
- Apply creative, analytical solutions to business problems, with the ability to remain nimble and pivot quickly when needed
- Collaborate with other department leaders and foster cross functional cooperation, especially with business development for referral management and clinical operations for patient on-boarding
- Exemplify company culture by modeling core values of the organization and ensuring staff understands values and mission
- Other related duties as assigned
Требования
- Bachelor's Degree required or an equivalent combination of education and experience. Masters in Social Work, Public Health, or Healthcare Administration, highly preferred.
- 5+ years of people management experience in a similar environment.
- Remote workforce and/or multi-site supervisory experience, required.
- 3+ years of care management experience, required. Strong understanding of managed care programs (i.e medicare, medi-cal etc), highly preferred.
- Experience with Enhanced Care Management programs, highly preferred.
- Proven, results-driven business leader with P&L responsibility experience.
- Superior organizational skills to orchestrate internal and external meetings driving outcomes.
- Self-directed, entrepreneurial leader with the flexibility and tenacity to thrive in a fast-paced, high-growth, dynamic environment.
- Proficient with Microsoft and Google applications, plus general computer literacy.
- Strong adaptability to work collaboratively and cross-functionally in a remote environment.
- Must have access to reliable internet connection.
- Ability to work with complex and multifaceted tasks and systems.
- Experience working with culturally, ethically, sexually, and socio-economically diverse populations with the ability to maintain sensitivity in all interactions.
- Experience working with multidisciplinary teams.
- Willing and able to travel a minimum of quarterly for leadership and team meetings, including staff training.
- Willing and able to support Pacific Time core business hours (Monday-Friday, 8:30am-5pm).
Другое
- Join the dynamic journey at , where we're passionate about transforming care for individuals with complex needs. We’re more than just a team; we're a close-knit community. Our shared commitment to caring for each other and those we serve is what sets us apart. Guided by our unwavering core values: Excellence, Compassion, Curiosity, and Integrity, we forge paths of success together. Join us in this transformative movement where you can contribute to making a profound difference every day. At , our mission is to provide comprehensive care for more quality days at home.
- The hiring process for this role may consist of applying, followed by a phone screen, online assessment(s), interview(s), an offer, and background/reference checks.
- Background Screening: A background check, which may include a drug test or other health screenings depending on the role, will be required prior to employment.
- Job Description Scope: This job description is not exhaustive and may include additional activities, duties, and responsibilities not listed herein.
- Vaccination Requirement: Employees in patient, client, or customer-facing roles must be vaccinated against influenza. Requests for religious or medical accommodations will be considered but may not always be approved.
- Employment Eligibility: Compliance with federal law requires identity and work eligibility verification using E-Verify upon hire.
- Environmental Conditions and Physical Requirements: Works with patients/clients remotely and/or in-person. Successfully performs the essential duties and responsibilities of the position through the use of physical activities as described below: Regularly requires sitting, standing, walking, talking, use of hands, listening, and observing.
- Regularly requires working at a computer for an entire shift (with appropriate breaks).
- Regularly requires use of laptop and video-conferencing technology.
- Occasionally requires reaching, stooping, bending, kneeling, and lifting items weighing 25 pounds or less.
- Occasional travel may be required to perform job duties, attend training, or company events.