Sr. Director, Integrated Care

Continuum Health Alliance   •  

Marlton, NJ

Industry: Healthcare

  •  

11 - 15 years

Posted 115 days ago

Overview

As a physician enablement company, Continuum Health delivers managed solutions to provider groups and aggregators, helping foster self-sufficiency by maximizing fee-for-service payments, transitioning them to value-based programs and preparing them for risk. Continuum also collaborates with payers to help drive value-based adoption among providers and improve the health outcomes of patients. The company optimizes performance through revenue cycle management, value-based care, practice management services and specialty care solutions. Nearly 2,000 physicians, specialists and nurse practitioners caring for millions of patients depend on Continuum’s business and clinical experts to help achieve their goals. Learn more at www.continuumhealth.net.

 

The Director / Sr. Director of Clinical Operations is an experienced, innovative and results driven leader who will manage the Care Coordination operations within the Integrated Care division. This role reports into the General Manager/Sr. VP for integrated Care.

POSITION PURPOSE:

 

The Director/Sr. Director of Clinical Operations will manage the integration of data, clinical information, medical activities and quality initiatives to lead all aspects of Practice Transformation and Care Coordination across the Integrated Care continuum. In this leadership role you will improve performance efficiencies by utilizing information structures, processes, best practices, and technology.

 

The Director / Sr Director of Clinical Operations will strive to improve the health of populations, communities, families, and individuals through an in-depth knowledge of commercial and governmental quality programs and initiatives.  This includes the use of technology in establishing/monitoring effective performance management metrics and key performance indicators.

 

The Director / Sr. Director of Clinical Operations will possess a detailed understanding and will skillfully use the techniques of system design, reengineering, project management, quality improvement, outcomes measurement, and statistical analysis. The Director / Sr. Director is responsible for educating and monitoring conformance to regulatory quality requirements, and cost of care for all Continuum Health clients.

Responsibilities

ESSENTIAL FUNCTIONS:

 

  • Assures that individual rights are honored, and that all interactions are respectful and valued.

 

  • Demonstrates a deep knowledge of population health management services and healthcare reimbursement/alternative payment methodologies.

 

  • Demonstrates deep knowledge of ambulatory care coordination workflows and processes.

  • Effectively builds and leads a team of professionals that perform complex care coordination across many different practices.


  • Works closely with outsourced vendors to build and maintain metrics-based performance on service deliverables.

  • Demonstrates an underlying knowledge of commercial and governmental quality programs to include, but not limited to: PCMH, Meaningful Use, MACRA, MIPS, HEDIS.

 

  • Monitors, analyzes, and reports on the adherence to all contractual obligations/deliverables for Continuums client base to Executive Leadership.

 

  • Synthesizes data, information, and knowledge to clarify/communicate key performance indicators (KPIs), client deliverables, and outcomes.

 

  • Analyzes multiple approaches/solutions to any performance deficiencies. Prepares weekly reports indicating contractual performance for applicable clients.

 

  • Reviews, revises and develops departmental policies, procedures and applicable workflows.

 

  • Works closely with IT to establish best practice for documentation in EMR and other population health applications.

 

  • Develops and trains new hires on clinical workflows utilizing client specific technologies.

 

  • Conducts annual employee performance reviews for all direct reports.

 

  • Maintains knowledge and competency that reflects current quality programs and other healthcare cost of care strategies.

 

  • Collaborates with other Continuum Health departments to ensure the triple aim of improved quality, improved patient satisfaction and engagement, and reduced overall healthcare spend is achieved for all clients.

 

  • Participates in inter and intra-departmental meetings as necessary.

 

  • Considers factors related to effectiveness, costs, and impact in conducting performance management.

 

  • Employs effective communications to all clients with routine face to face meetings.

 

  • Meets leadership competency requirements as specified below and carries out learning plan for ongoing personal development.

 

  • Other duties as assigned.

Qualifications

COMPETENCIES:

 

  • Core
    • Customer Focused
    • Developing Others
    • Interdependence (Team Focused)
    • Mission Centered
    • Open Communication

 

 

  • Project Leader
    • Organizational Knowledge
    • Project Methodology
    • Project Team Building
    • Results Oriented
    • Proven Leader in Integrated Care Processes

 

  • Service Delivery Leader
    • Building Relationships
    • Industry Expertise
    • Planning & Prioritizing
    • Problem Solving
    • Supporting & Implementing Change

 

  • Systems and Integration Leader
    • Analytic Decision Making
    • Industry and Regulatory Knowledge
    • Managing Projects
    • Decision-Making Support
    • Active Listening/Strong Communicator
    • Motivated Team Player

 

 

WORKING CONDITIONS AND PHYSICAL DEMANDS:

 

  1. Requires the ability to frequently respond to multiple demands and priorities.
  2. Travel to client sites required.

 

 

MINIMUM EDUCATION, LICENSURE, CERTIFICATION, AND EXPERIENCE REQUIRED:

 

  • Active Registered Nurse license (NJ)
  • Minimum of a Bachelor’s Degree in Nursing; Master’s Degree in Business Administration / Healthcare Administration/ Nursing highly desirable.
  • 10+yrs Clinical experience
  • 3-5yrs leadership experience and prior direct management of clinical staff

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