Regional Director Care Coordination
3 weeks ago
Job Summary: Responsible for the development of a care coordination strategy for populations requiring special care. This position has the responsibility for developing and implementing a strategy to identify a risk stratification plan to identify populations with complex needs, requiring special care and the development of interdisciplinary solutions and patient case review that will provide excellent care across the continuum for these populations. Essential Responsibilities: Provide executive level leadership and recommendations over areas of accountability. Provides leadership to health plan and medical group providers in the development of regional strategies to coordinate and plan the provision of health care services across the continuum of care for patients with complex needs. Creates the structure and processes to identify populations with complex needs and to develop, implement and evaluate programs, policies and standards for continuum of care services that develop coordinated plans of treatment and delivery systems to provide excellent service to those members with complex needs. Defines and communicates strategic objectives and scope. Articulates issues or problems from a broader organizational/mission perspective and escalates unresolved barriers and roadblocks. Champions new ways of meeting targets and/or goals. Explores critical issues not explicitly addressed by others. Anticipates and plans for future issues or problems. Monitors and assesses internal and external environment for trends and practices. Recommends operational improvements to increase efficiency and to meet changing business needs. Works with facility based leadership Region wide to develop and meet utilization targets and related quality goals. Works with KFH/HP, TPMG and labor leaders to target diseases/conditions/services that would benefit from a regional or statewide multidisciplinary approach. Working with regional and local leaders to develop a systematic approach to identify and enroll members in existing and new programs along with consistent services in local areas as well as across the region (model of care, interdisciplinary team, interventions, connection to community resources, etc) and infrastructure. In partnership with key physicians and data team leads, develops care population segmentation model for improving outcomes for members with complex needs. Working with an interdisciplinary team to design assessment tools, interventions and Care Management plans that lead to improved member outcomes and used throughout the continuum of care. Accountable for the development and implementation of Northern Californias regional strategy to ensure that Northern California Kaiser Permanente has sufficient presence to fulfill our mission, continue influence in public policy and maintain our tax exempt status. Together with local area leadership develops a Medicaid growth strategy by service area supported by a care delivery/care management model to effectively serve the needs of this population in a high quality, patient-centered and cost effective manner. Models and reinforces ethical behavior in self and others in accordance to the Principles of Responsibility, adheres to organizational policies and guidelines, supports compliance initiatives, maintains confidences, admits mistakes, conducts business with honesty, shows consistency in words and actions, and follows through on commitments. Regional leaders are accountable for communication, implementation, enforcement, monitoring, and oversight of compliance policies and practices in their departments. Basic Qualifications: Experience Minimum ten (10) years in the health care industry Education Bachelors degree in nursing, business or related field. License, Certification, Registration N/A Additional Requirements: Demonstrated strong interpersonal/communication skills. Strong presentation, leadership, project management and consultative and problem solving skills required. Ability to lead and manage through influence and change. Demonstrated ability to lead professionals through influence and collaboration. Understanding of and experience in process improvement and the tools and data requirements for supporting an effective process improvement practice. Must exhibit efficiency, collaboration, candor, openness and results orientation. Strong verbal and written communication skills and presentation skills required. Decisiveness, action-orientation, personal integrity, capability to persevere in difficult situations and a focus on strategic leadership issues highly desired. Possess an open collaborative leadership style that promotes teamwork and partnership while achieving desired results. Thorough knowledge of quality assurance, resource management, health plan regulatory and licensing processes including federal and state laws and regulations such as: Knox-Keene Act, Federal HMO Act, Public Employees Medical and Hospital Act, JCAHO, and all applicable Medicare and Medi-Cal regulations. Demonstrated understanding of health policy trends and any applicable regulations. Understanding of the operations of KP preferred. Must be able to work in a Labor/Management Partnership environment. Preferred Qualifications: Experience in a high level administrative capacity within multi-faceted health care system and multi-service provider setting Masters degree strongly preferred. COMPANY: KAISER TITLE: Regional Director Care Coordination LOCATION: Oakland, California REQNUMBER: 1306315 External hires must pass a background check/drug screen. Qualified applicants with arrest and/or conviction records will be considered for employment in a manner consistent with Federal, state and local laws, including but not limited to the San Francisco Fair Chance Ordinance. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, sexual orientation, gender identity, protected veteran, or disability status.
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