Working collaboratively with the Clinical Services Leadership Team, lead the clinical workstreams to design, launch and implement new clinical programs including internal and purchased programs. Includes clinical program design and development, external market scans for emerging clinical program trends, evaluation of build vs. buy business cases, assessment of vendor solutions, support of go-to-market processes and RFP proposals. Provides cross-functional leadership to bring new clinical programs to market with hand offs to Clinical Services operational leaders for on-going management and sustainment of new clinical programs. Works collaboratively with Clinical Services leaders and vendor management team, Cambia Health internal partners including Sales, Marketing, Product, Strategic Finance and Sourcing; and external partners and vendors. Responsible for driving the Clinical Services strategic roadmap and priorities, strategic initiatives, annual operating plan and clinical scorecard. Oversees staff providing related communication and reporting support.
- In partnership with clinical leaders, assesses market trends and evaluates need for new program offerings.
- Facilitates development of strategic initiatives, roadmaps, scorecards and RFPs for Clinical Services.
- Effectively leads tactical execution of large scale, complex clinical transformation programs.
- Establishes and maintains program management practices and process, actively supporting Clinical Services goals and objectives.
- Provides day-to-day leadership of cross-functional project teams comprised of business, technology and vendor/consulting resources.
- Creates a sense of urgency within the organization and translates quickly evolving directions into action.
- Trains the organization on all program related changes as necessary and drives communication strategy across functional teams and the organization
- Works closely with cross-functional leaders to clarify program goals and create operational plans to ensure successful execution of the relationship with our provider partners.
- Works collaboratively with teams to plan, design, develop, implement, and manage programs to ensure ongoing performance expectations for the program are met.
- Represents program goals and initiatives with various audiences. Cultivates and maintains relationships with key internal and external stakeholders.
- Develops and oversees monitoring and reporting procedures to ensure deliverables and budget are on track. Communicates program status and areas of risk or opportunity.
- Handles all management level responsibilities for direct staff, including performance reviews, employee development, hiring, coaching, counseling, and retention.
- Partners with cross-functional leaders, provider groups, and vendors to lead organizational change.
- Expertise in health plan clinical programs with a focus on population health and care coordination.
- Experience in areas such as care management models, partnerships with providers, third-party suppliers of clinical services, community groups and other member-touching stakeholders.
- Proven ability to lead the design, development and implementation of process, structure, tools and measurement indicators that drive operational results.
- Demonstrated experience leading a large scale, complex business transformation and/or system implementation in a multi-state environment.
- Experience in new product/service development, especially in healthcare and/or with a significant information technology compliment; demonstrated success in leading product/service development teams.
- Demonstrated ability to work collaborative and cross-functionally and organize cross functional activities to deliver results in a matrixed organizational structure.
- Excellent judgment, problem solving, creativity, flexibility, analytical, communication and presentation skills.
- Experience with business process redesign and optimization including ability to recognize process deficiencies and recommend and implement improvements.
- Excellent written and verbal communication skills, ability to present and facilitate and drive executive level discussions and strong customer and stakeholder management skills.
Normally to be proficient in the competencies listed above:
- Program Director, Clinical Programs and Performance, would have a Bachelor’s degree in nursing or behavioral health or Master’s degree in healthcare administration, public health or related field, 8 years of experience in project and/or program management preferably in Clinical Case Management, and/or Population Health, including management/leadership experience or equivalent combination of education and experience.
- Professional license in nursing, psychology or related clinical field preferred.