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Head of Integrated Care Management

2 months ago

Philadelphia, Pennsylvania, United States Community Behavioral Health. Full time
Position Overview

The Head of Integrated Care Management is essential in delivering extensive cohort management initiatives aimed at improving health outcomes for individuals facing intricate medical, behavioral, and social challenges. In this leadership role, you will significantly contribute to enhancing patient outcomes, refining care delivery processes, and expanding the organization's integrated care programs.

This position requires leveraging your educational background and extensive experience in integrated care models, particularly focusing on complex cohort management to provide holistic, tailored, and thorough care coordination. These initiatives will engage with healthcare partners, community organizations, and other vital stakeholders.

Key Responsibilities:

  • Collaborate with senior leadership to define and execute the vision for integrated care teams serving diverse populations, thereby improving overall member well-being.
  • Guide the development and implementation of the integrated care program in alignment with regulatory, evidence-based, and accreditation standards.
  • Act as the representative for senior leadership in matters concerning the integrated care program.
  • Oversee daily operations and leadership functions of the integrated care teams, ensuring adherence to best practices in care management.
  • Work closely with utilization review teams to enhance care delivery and outcomes.
  • Monitor clinical data and outcomes, ensuring compliance with relevant regulations and standards.
  • Employ continuous quality improvement methodologies to enhance the effectiveness of integrated care programs.
  • Collaborate with various departments to develop and implement interventions targeting specific performance measures.
  • Utilize a holistic approach to lead teams in creating comprehensive care plans that address the unique needs of each member.
  • Provide clinical oversight to coordinators to assess and address risks associated with complex cases.
  • Facilitate problem-solving for members experiencing crises when standard interventions have been exhausted.
  • Direct multiple integrated care teams to ensure high-quality, patient-centered care management.
  • Manage workforce planning, including recruitment, performance evaluations, and professional development.
  • Engage in cross-departmental collaborations to identify opportunities for improved resource management and communication.
  • Lead clinical reviews with relevant oversight bodies.
  • Prepare and disseminate clinical and quality data to inform decision-making and guide interventions.
  • Develop new integrated care programs focused on specific populations.
  • Model exceptional customer service in interactions with members and providers.
  • Establish productivity expectations for clinical staff.
  • Encourage a culture of innovation and professional growth among team members.
  • Participate in budgeting and resource allocation processes to optimize resource utilization.
  • Perform additional duties as required.

Qualifications:

  • Education: Doctoral degree in a relevant field preferred; Master's degree in social work or related discipline with substantial leadership experience accepted.
  • Licensure: Relevant licensure preferred; background checks required.
  • Experience: Minimum of five years in a leadership role, with a focus on complex care management.

Skills:

  • Excellent verbal and written communication abilities.
  • Strong interpersonal skills for building collaborative relationships.
  • Analytical skills for interpreting data and generating reports.
  • Proficient in preparing presentations for various stakeholders.
  • Understanding of mental health and substance use services.
  • Commitment to enhancing services for underserved populations.
  • Knowledge of integrated health care approaches and ongoing professional development.
  • Ability to drive innovation and apply industry best practices.
  • Familiarity with social determinants of health and health disparities.
  • Proficient in Microsoft Office and other relevant software.
  • Strong organizational and leadership skills.

Core Competencies:

  • Collaboration: Foster relationships and encourage teamwork.
  • Respect: Value diversity and treat all individuals with dignity.
  • Member Focus: Prioritize the needs of members and deliver exceptional service.
  • Integrity: Uphold ethical standards in all actions.
  • Service Excellence: Strive for high-quality, innovative programs.

Work Environment:

  • Ability to travel as needed.
  • Regularly engage in physical activities associated with office work.
  • Adaptability to changing job demands.

Equal Opportunity Employer:

We are committed to fostering a diverse and inclusive workplace. All qualified applicants will receive consideration without regard to race, ethnicity, gender, disability, or any other characteristic protected by law.