[Hiring] Director of Enhanced Care Management @Vynca

Role Description

The Director of Enhanced Care Management is responsible for directing and overseeing operations of the enhanced care management program. This includes:

• Responsibility for Cal AIM program performance
• Provider and community collaboration/engagement
• Oversight of the care management specialists
• Policy development
• Process improvement/program enhancements
• Managing interdependencies and risks
• Developing growth opportunities

The director works on projects from the point of conceptualization up to the implementation stages, and is responsible for resolving complex problems. They support the VP of Clinical Operations in the development of strategy that results in better health quality outcomes, better patient care, and lower cost of care.

The Director will develop, implement, supervise, and manage Vynca’s Enhanced Case Management Program, supervising Clinical Managers, Clinical Consultants, and Lead Care Managers. Responsibilities include:

• Administering the ECM program
• Developing linkage with healthcare plans
• Outreach and creating clear access to the ECM program
• Program evaluation and staff supervision

At this time we are only considering applicants in the following states: Arizona, California, Colorado, Illinois, Nevada, Oregon, Texas, Utah, and Washington.

Qualifications

• Bachelor's Degree required or an equivalent combination of education and experience
• Masters in Social Work, Public Health, or Healthcare Administration, highly preferred
• 5+ years of people management experience in a similar environment
• Remote workforce and/or multi-site supervisory experience, required
• 3+ years of care management experience, required
• Strong understanding of managed care programs (i.e medicare, medi-cal etc), highly preferred
• Experience with Enhanced Care Management programs, highly preferred
• 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 flexibility and tenacity
• 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
• Experience working with multidisciplinary teams
• Willing and able to travel a minimum of quarterly for leadership and team meetings
• Willing and able to support Pacific Time core business hours (Monday-Friday, 8:30am-5pm)

Requirements

• Refine and implement program policies and procedures
• Supervise Clinical Managers, 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 staffing and staff training
• Run EHR reports as needed
• Oversee claims submission, denials, and receipt of payments
• Attend meetings and represent the organization with the public, local businesses, employers, health plans, vendors, regulatory and outside vendors
• Provide 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
• 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
• Collaborate with other department leaders and foster cross-functional cooperation
• Exemplify company culture by modeling core values of the organization
• Other related duties as assigned

Benefits

• The hiring process may consist of applying, followed by a phone screen, online assessment(s), interview(s), an offer, and background/reference checks
• A background check, which may include a drug test or other health screenings, will be required prior to employment
• This job description is not exhaustive and may include additional activities, duties, and responsibilities
• Employees in patient, client, or customer-facing roles must be vaccinated against influenza
• Compliance with federal law requires identity and work eligibility verification using E-Verify upon hire
• At Vynca Inc., we embrace diversity and are committed to fostering an inclusive workplace