The VP, Care Management is accountable for the successful operation of the clinical components of our model of care including utilization management, care management and remote patient monitoring. Responsible for strengthening relationships with our affiliate provider partners through upholding our clinical model service and standards, this leader will oversee the recruitment, training and management of multi-disciplinary care teams that are embedded in the practice. In addition to the provision and oversight of clinical services, the VP, Care Management will leverage payor content knowledge to ensure care teams execute against established goals across multiple payors. This individual will also contribute to long-term strategic programming including the identification and launch of services that advance our mission.
How you can make a difference
The successful candidate will demonstrate a strong track record of building and leading teams. He/she will balance vision with a hands-on approach and will be comfortable driving results independently, as well as with and through others. Ability to navigate within ambiguity, a service orientation, and a high level of humility are all requirements for successful assimilation into our highly collaborative, entrepreneurial culture. While the role will be dynamic in nature, key responsibilities of this leader include:
- Designing clinical service delivery for UM, CM, and RPM aligned with organizational goals for clinical, financial and experience outcomes across all independent practice groups.
- Collaborating with multi-disciplinary teams to execute care management responsibilities including close partnership with clinicians, operations and analytic functions.
- Developing and implementing the process and infrastructure to ensure patients are appropriately placed after discharge from the hospital.
- Collaborating to lead planning, execution, and operations management across the clinical platform to support continued growth.
- Designing and executing a framework for care management service implementation for new physicians; continuously reviewing and refining for efficiency and effectiveness.
- Measuring clinical outcomes and improvement opportunities by leveraging internal and external benchmarking to build team action plans and proactively address opportunities for improvement.
- Building, maintaining and leveraging relationships across company and our partners including collaboration within the population health operations leadership structure to execute on organizational strategy.
- Managing daily operations of the clinical team, integrating workflows with physicians, practice staff, and internal teams to achieve outcomes and eliminate barriers to success.
Skills for success
- The ability to be flexible in an ambiguous and dynamic environment
- The ability to adapt quickly to changing demands in the healthcare industry
- A service orientation and a “can do” attitude
- A willingness to learn independently and take initiative
- Displays Strength-Based Approach to collaborative problem solving
- The ability to receive feedback and apply it to work performance
- Demonstrates consistently, strong ethics and sound judgement
- Effectively engages diverse populations (age, ethnic groups, socio-economic levels, etc.) and provide culturally sensitive coaching, education and assistance to members and their families
- Experience in conflict management and problem resolution
- A low ego and humility; an ability to gain trust through good communication and doing what you say you will do
Experience to drive change
- Bachelor’s Degree in Nursing required with a strong preference for an advanced degree.
- Minimum of 7 years clinical experience in an acute, ambulatory or primary care practice setting required.
- At least 5 years of direct management experience leading teams.
- Case Management and/or previous value based care experience strongly preferred.
- Current RN with licensure, or eligible for licensure in Texas.
- Proven track record building and leading teams in a high growth environment.
- Demonstrated business and financial acumen, strategy development and execution and operations management.
- Highly relational with the ability to forge meaningful partnerships with physicians.
- In-depth, working knowledge of state and national regulatory guidelines.
- Balances strategic ability with an affinity for operations; not afraid to dig into the details of the work to influence a positive outcome.
- Experience with quality improvement methodology, practice and execution.
- An orientation towards data, measurement and outcomes; highly accountable with proven ownership of results.
- Strong persuasion and presentation skills; the ability to lead multi-disciplinary groups to action and desired outcomes.
- Experience working successfully with diverse stakeholder groups, establishing the required relationships to work collaboratively across all levels of a complex organizational structure.
- Detail oriented and well organized; effectively manages competing priorities.
- Positive attitude coupled with a solution-oriented approach and a comfort working within ambiguity.
- Comfortable with technology, and literate in the Microsoft office suite of products including Outlook, Word, Excel and Power Point.