Senior Director, Clinical Delivery

bright health plan   •  

Kansas City, MO

Industry: Healthcare

  •  

11 - 15 years

Posted 50 days ago

The Senior Director, Clinical Delivery will build and lead a team responsible for the execution of Population Health and Network Navigation initiatives. This is a senior role within Bright's Health Optimization (Clinical) team, that will have accountability for operating a new clinical center of excellence (CCOE) being established within Bright's Lee's Summit location. Responsibilities include coordinating with cross functional leaders to understand how the CCOE can support the plan's business strategy, providing direct leadership of CCOE call center teams, establishing standard operating procedures in alignment with program policies and developing staffing models that scale with Bright's growth. The Senior Director, Clinical Delivery will ensure applicable CCOE programs meet all applicable state and/or federal regulatory requirements in addition to corresponding URAC standards.


Role Responsibilities

  • Develop operating models to execute clinical program solutions, including but not limited to Complex Case Management, Disease Management, Transitions of Care and Network Navigation
  • Develop and maintain staffing and scheduling plans to meet departmental objectives as provided by leadership, including meeting specified service levels (e.g. average speed of answer and abandonment rates)
  • Recruit, hire and train new team members
  • Support development of, and maintain, policies and procedures related to corresponding CCOE functions
  • Provide an inspiring leadership vision for CCOE teams that serves Bright members, aligns with Bright's core values and meets stated performance targets
  • Collaborate with cross functional leaders, including, but not limited to Network Navigation, Product, Clinical Program Management and Constituent Services to identify opportunities for service improvement, including further integration with Bright's Care Partners where appropriate
  • Consolidate and provide feedback to Program Management team with respect to program design, efficiency, efficacy and member/provider satisfaction
  • Establish monitoring processes to evaluate the execution of applicable CCOE functions
  • Participate in and/or lead the implementation of new clinical initiatives and/or new market installations
  • Represent the CCOE within Bright Committee structures to report program performance and provide operational updates
  • Manage workplans and prioritize resources to meet key deliverables
  • Other duties and responsibilities as assigned

Eduction, training, and professional experience

  • Bachelor's degree or higher required
  • A Bachelor's degree in a clinically related field is preferred, but not required.
  • Ten or more years of professional experience, including five years within a leadership role in a call center/consumer engagement center with accountability for staffing, scheduling and performance management
  • Prior experience with URAC accreditation is desired
  • Formal training in Six Sigma management techniques is a plus, but not required

Professional comptencies

  • Strong operational mindset and use data to draw insights
  • Motivational leader that seeks to inspire teams to perform rather then a dependence on authority
  • Thrives on driving results in a collaborative environment

The majority of work responsibilities will be performed in an office/call center environment. Up to 10% travel to Minneapolis required.


ABOUT US

At Bright Health, we brought together the brightest minds from the health care industry and consumer technology and together we created Bright Health: a new, brighter approach to healthcare, built for individuals. Our plans are easy to manage, personalized and more affordable, giving people the quality care they deserve. Through our exclusive care partnerships with leading health systems in local communities we are reshaping how people and physicians achieve better health together.

Bright Health is tripling its footprint in 2019 to offer a variety of health insurance plans to more individuals. Bright Health operates health insurance offerings across Individual and Family Plan segments and the Medicare Advantage space in Alabama, Arizona, Colorado, Ohio, New York and Tennessee.

We're Making Healthcare Right. Together.


We've won some fun awards like: Great Places to Work, Modern Healthcare, Forbes, etc. But more than anything, we're a group of people who are really dedicated to our mission in healthcare. Come join our growing team!

As an Equal Opportunity Employer, we welcome and employ a diverse employee group committed to meeting the needs of Bright Health, our consumers, and the communities we serve. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law.