Director of Care Coordination

SUMMARY The Director of Care Coordination possesses a practice operations background with experience in population health practices and principles.
This person will direct and manage the daily work of the multiple Care Coordination teams and supports the implementation of new programs identified by SVHC Leadership Team.
Provides leadership for the development, deployment and optimization of population healthcare services by managing the Care Coordination teams comprised of, but not limited to, RNs, LVNs, Community Health Workers, Population Health Coordinators, Referral Coordinators, New Patient Coordinators, Prescription Coordinators and Patient Access Coordinators.
Responsible for leading the team to ensure optimal care for priority patient populations identified through the strategic work plan and other defined stratification processes.
Contributes to the mission and strategic goals of SVHC by leading initiatives to iterate, refine, and improve integrated services, assuring compliance with applicable federal and state laws as well as local agencies.
Responsible for achieving programmatic requirements with other entities and payors such as the National Committee for Quality Assurance (NCQA), Centers for Medicare and Medicaid services (CMS), and Central California Alliance for Health (CCAH).
The person in the position of the Director of Care Coordination must be able to perform the duties described within as well as to meet the company’s qualifications regarding education, experience, patient service, attitude, language skills, meet physical requirements, possess strong clinical and analytical skills.
ESSENTIAL DUTIES AND RESPONSIBILITIES Includes but not limited to the following: Manages personnel within the Care Coordination department including but not limited to interviewing, hiring, performance management, staff development, disciplinary action, etc.
Manages the daily work of the Care Coordination department and supports implementation of new programs.
Leads the Care Coordination department by demonstrating the capacity and expertise to operationalize best practice recommendations, system goals, and regulatory requirements.
Coordinates activities with key staff and implements changes and interventions to achieve improvement targets.
Communicates with the team and continually evaluates plans in keeping the departmental priorities and initiatives on track including program implementation and progress towards programmatic metric goals.
Communicates and collaborates with multidisciplinary healthcare team members, emphasizing continuity of care, in an effort to reduce or eliminate fragmentation, duplication, and gaps in treatment plans.
Provides clear, strategic, and operational direction to enhance the value of services provided to the patients, hospitals, and providers.
Leads initiatives to achieve recognition as Patient-Centered Medical Homes (PCMH) under NCQA standards.
Participates in initiatives around value-based contracting and reimbursement systems to gain a comprehensive understanding of programmatic goals, metrics, and priorities in optimizing patient care.
Develops and maintains standards following best practices for population health workflows aligned with an integrated, cross disciplinary team.
Develops and optimizes care management registries within Epic, aligned with SVHC’s identified population health needs.
Develops and monitors population health performance standards which include key performance indicators and performance targets focusing on improving healthcare outcomes.
Monitors metrics and benchmarks to drive improvement and raise awareness that promotes individual growth and collective improvements in care within Care Coordination department as well as across SVHC’s multidisciplinary team.
Identifies baseline workflows and process gaps within SVHC in order to make enhancement recommendations and implement change processes, through in-depth system knowledge.
Facilitates, plans, and leads recurring meetings with stakeholders and SVHC’s Leadership Team.
Works closely with analytics team to provider reports allowing SVHC providers to address the populations directly attributed to them and further provide better care, improve health, and lower costs.
Regularly attends various meetings, conference calls and training seminars.
Must be able to grasp the pertinence of the subject and re-deliver or train others on the topics related to population health and care coordination activities.
Maintains awareness of regulations, keeping abreast of pending and or implemented changes.
Maintains the strictest confidentiality in the areas of patient, employee and provider relations.
Other duties as assigned.
EDUCATION and/or EXPERIENCE 5-7 years prior experience as a medical practice manager or quality/population health manager with a medical practice of more than 15 physicians.
Ability to work cooperatively with physicians and management teams.
Bachelor’s degree required, in a related field preferred MHA, MBA or Master’s Degree in a field related to healthcare or business administration is strongly preferred.
REQUIREMENTS: Current California Driver’s License, reliable vehicle and proof of insurance.
Offer is contingent upon successful completion of a background check.
QUALIFICATIONS To perform this job successfully, an individual must be able to perform each essential duty satisfactorily.
The requirements listed below are representative of the knowledge, skill, and/or ability required.
Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
Excellent communication, interpersonal, and organizational skills Extensive experience with Epic Creative, flexible and easily adapts to changing priorities Energetic, takes initiative and able to work in a team environment as well as autonomously when needed Exhibits a strong work ethic.
This individual must be innovative, efficient, and results focused.
Understanding of clinical program development and improvement, analytical problem solving, project management, and ability to positively influence others.
Ability to navigate ambiguity with the aid of structured problem-solving techniques.
Understanding of value-based payment systems such as CMS’s Primary Care First, Medicare Shared Savings Program, Merit-Based Payment System, PCMH, PCSP, etc.
PREFERRED Bilingual may be required at certain clinics or during certain shifts.
SUPERVISORY RESPONSIBILITIES This position supervises the Practice Managers for Care Coordination and Population Health.
Direct management responsibility of 50-60 clinical and non-clinical staff.
Carries out management responsibilities in accordance with the organization's policies and applicable laws.
CONDITION OF EMPLOYMENT: Salinas Valley Health Clinics requires you to prove that you have received the COVID-19 vaccine or have a valid religious or medical reason not to be vaccinated.
In addition, new hires must prove that they have received a booster dose of the COVID-19 vaccination if eligible or must receive a booster dose of the COVID-19 vaccination within 15 days after becoming eligible.