Vice President of Health, Clinical Integration

Community Care of North Carolina (CCNC) - Raleigh, NC (30+ days ago)4.0


Vice President, Clinical Integration

Position Summary

As a member of the Central Office Leadership Team, the Vice President of Clinical Integration provides leadership and oversight regarding the development, implementation, and coordination of services among the Clinical Programs and Care Management teams. The Vice President of Clinical Integration works collaboratively with CCNC’s Chief Medical Officer, Senior Vice President of Population Health Solutions, Vice President of Clinical Operations and regional Network leadership to achieve organizational goals regarding Population Health Solutions. This position will directly supervise the Care Management and Clinical Programs leadership staff.

Essential Functions

  • Collaborates with Medical Director leadership on the development and implementation of Population Health service delivery programs and initiatives.
  • Provides strategic perspective and direction within Population Management program activities and service delivery
  • Supervises and mentors both Clinical Programs and Care Management leadership staff.
  • Ensures that clinical staff adheres to appropriate guidelines and standardized processes in the implementation of best practices in Population Health service delivery.
  • Leads the integration of best practices to ensure continuous quality improvement and cost containment efforts.
  • Implement a strategic short and long-term infrastructure strategy for clinical programs.
  • Oversee the development of new models of Population management (e.g. specialty populations, commercial populations, practice support)
  • Analyze operational procedures and recommend changes to improve the effectiveness and efficiency of clinically integrated programs across the service continuum.
  • Ensure that CCNC obtains appropriate accreditation and/or recognition, such as NCQA recognition for Care Management.
  • Ensure maximum quality and satisfaction with external customers and maintain an effective working relationship (e.g. DHHS, MCOs, VirtualHealth, Healthwise, etc).
  • Participate in marketing activities with external customers and partners.
  • Participate in the development of reimbursement strategies, evaluation of contracting options and assessment of outcomes related to these strategies.
  • Ensure client, provider and patient satisfaction surveys and efforts occur and analyze results for continuous quality improvement activity.
  • Assist in developing and meeting annual budgetary and organizational goals.
  • Implement standardized communication techniques to assure alignment across programs
  • Create metric reports that summarize the results of Population Management service initiatives and strategies.
  • Collaborates with the Analytics, Reporting, and Technology to integrate data analytics to maximize clinical impact and intervention.
  • Foster collaborative relationships with provider, consumer systems and payer organizations to support goal achievement and improve upon Population Health delivery systems.
  • Collaborate in ensuring the viability of the organization through the development of appropriate state-wide guidelines, standardization and expectations.
  • Ensure appropriate growth in centralized support that ensures economies of scale and supports state-wide activities, such as member portal and wellness coaching.
  • Facilitate optimal program integration across all CCNC Population Health programs to ensure consistency of quality and collaboration to meet program-specific needs related to Population Health activities. These programs include, but are not limited to the following:
  • Medical leadership
  • Quality Management
  • Quality Improvement
  • Clinical Operations
  • Pediatrics (CC4C, Health Check)
  • Adult Health
  • OB Care Management/Pregnancy Medical Home
  • Behavioral Health
  • Palliative Care
  • Pharmacy
  • Special Populations (e.g. Sickle Cell, Hep C, etc.)
  • Practice Support
  • Analytics, Reporting, and Technology

Key Activities

  • Onboard new pharmacies, networks, and partners to CPESN from the initial point of interest to active membership
  • Manage contracts, amendments, and related information for existing participants and partners
  • Maintain pharmacy demographics, user demographics, communication lists, and LMS requirements in the master database(s)
  • Assist with facilitation of CPESN workgroup sessions and meetings, including scheduling, setting the agenda, communicating with participants, taking minutes, and triaging follow up
  • Maintain action items for ongoing progress of CPESN Network launch phases
  • Periodically audit the status of customer accounts to keep profiles up to date
  • Provide telephone and email support to developing networks, luminaries, local account managers, partners, and participants
  • Clearly track and communicate the progress of monthly/quarterly initiatives to internal and external stakeholders

Requirements

  • Demonstrated leadership skills with the ability to apply critical thinking and strategic planning in the development, implementation and monitoring of Population Health programs.
  • Demonstrated expertise in Quality Improvement and Population Management approaches.
  • Excellent leadership and supervisory skills, as well as oral and written communication, and planning and decision-making skills.
  • Demonstrated understanding and ability to create strong partnerships and positive working relationships with internal colleagues, customer organizations and community and state-based agencies.
  • Demonstrates the ability to embrace and understand the change process and effectively guides others through change.
  • Knowledge of case management standards of practice based on Case Management Society of America (CMSA)
  • Ability to analyze data related to disease burden, utilization, care management activity, productivity, etc. in effort to identify opportunities for improvement and best practices
  • Fluent in Microsoft Office applications, including Word, Excel and PowerPoint, etc.
  • Knowledge and experience of facilitating holistic care, based on the Chronic Care Model, with the ability to support regional Network processes targeted to improve quality of care and outcomes within primary care practice, hospital, home care, and other settings.
  • Experience with Quality Improvement methodology and techniques such as Six Sigma, Lean, and Institute for Healthcare Improvement (IHI) Model for Improvement, etc.
  • Ability to manage time well and prioritize multiple projects across a variety of topics and a wide-range of staff/disciplines
  • Creative and effective presentation skills

Education and Experience

  • Masters level degree in Nursing, Social Work or other Health Care related field
  • 5 or more years of progressive leadership experience in a health care setting
  • Current market knowledge and leadership experience with care management and population health programs across public and private payers
  • Understanding of the Primary Care Case Management (PCCM) model
  • Knowledge about medical policy, population management strategies and services

Working Conditions

  • Multiple contacts are required with external stakeholders
  • Routinely there may be some minor physical inconveniences or discomforts in the work setting, including sitting for moderate periods of time
  • Must be able to utilize office equipment, computer, keyboard and phone with or without assistive devices
  • Repetitive wrist motion and occasional lifting/carrying of up to 25 pounds
  • Travel using personal vehicle may be required within the region and/or the State

To qualify, applicants must be legally authorized to work in the United States, and should not require, now or in the future, sponsorship for employment visa status.

CCNC is an equal opportunity employer.

Job Type: Full-time

Education:

  • Master's