Director, Enhanced Care Management

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Requirements:

• Bachelors Degree, highly preferred
• 5+ years of people management experience
• 3+ years of care management experience
• Proven, results-driven business leader with P&L responsibility experience
• Superior organizational skills to orchestrate internal and external meetings driving outcomes
• Self-directed, entrepreneurial leader with the flexibility and tenacity to thrive in a fast-paced, high-growth, dynamic environment
• Proficient with Microsoft and Google applications, plus general computer literacy
• Strong adaptability to work collaboratively and cross-functionally in a remote environment
• Must have access to reliable internet connection
• Ability to work with complex and multifaceted tasks and systems.
• Experience working with culturally, ethically, sexually, and socio-economically diverse populations with the ability to maintain sensitivity in all interactions.
• Experience working with multidisciplinary teams

Responsibilities:

• Refine and implement program policies and procedures.
• Supervise Clinical Managers, Clinical Consultants, Lead Care Managers, and Support Staff.
• Oversee day to day ECM program.
• Ensure that ECM contract goals and objectives are met.
• Ensure contract regulatory and data requirements are met.
• Ensure records (electronic and physical) and billing requirements are kept up to standards.
• Oversee assessments, intakes, care planning, crisis management, transition plans.
• Oversee and ensure staff training.
• Run EHR reports as needed.
• Oversees claims submission, denials, and receipt of payments.
• Attends meetings and represents the organization with the public, local businesses, employers, health plans, vendors, regulatory and outside vendors.
• Provides reports to management and managed care plans regarding ECM as needed.
• Responsible for CalAIM program performance and successful execution of all SLAs
• Oversee all aspects of running an efficient team, focusing on role definition and attainment of goals
• Design and implement standard operating procedures and workflows for the department
• Develop strategic messaging that conveys the company’s value proposition and overcomes patient objections
• Manage quality assurance programs to enhance the client experience
• Develop KPIs that align team member performance to business objectives
• Manage P&L and report accurate business results in monthly operations reviews
• Apply creative, analytical solutions to business problems, with the ability to remain nimble and pivot quickly when needed
• Collaborate with other department leaders and foster cross functional cooperation, especially with business development for referral management and clinical operations for patient on-boarding
• Exemplify company culture by modeling core values of the organization and ensuring staff understands values and mission
• Other related duties as assigned.