Remote Divisional Director of Care Management, Strategy & Ops

Conviva

Apply Now

Location: Tampa, FL
Location Type: Remote
Schedule: Full_time
Req: R-325396

Become a part of our caring community and help us put health first

The Divisional Director is responsible for building a strong partnership with clinical-operational divisional dyads (Division CMO/Division Ops Leader) on care integration team foundational programs and future strategic opportunities for managing populations and coordinating care to reduce acute and post-acute care utilization. The Divisional Director role is a hybrid with travel requirements to facilitate and liaise relationships between market dyad leaders (i.e., Market CMO, Market President, RMDs) and CIT market managers and supervisors. The Divisional Director will also be a key consultant partner to market dyad leaders in understanding and creating solutions that will lead to acute and post-acute care utilization reductions aligned with the PCO’s objectives and goals.

As a guideline, this role involves spending 30% of the time on operational excellence and program implementation, 40% on relationships (vertically and horizontally), 20% on strategy, and 10% on career growth and development

               

Key Performance Indicators:

  • Market Provider and operations team experience of CIT, measured by achieving meaningful patient-provider engagement, improving provider capacity by reducing administrative work related to population health management, and improving NPS provider trust scores
  • Patient experience as measured by NPS scores, patient center engagement, churn rate, and patient’s engagement in own health
  • Positive associate experience, measured by associate engagement in annual company surveys, turnover rates that are like national benchmarks, and survey responses related to being on the One Care Team
  • CIT program impact on high-risk patient populations, measured by decreasing acute and post-acute care utilization to meet or exceed annual benchmarks set by the organization. This must include the ability to drive a team-based approach and work as an interdisciplinary team to assess and develop care plans for complex patients and coordinate care with Centerwell as well as outside providers (hospitals, SNFs, ERs, CBOs)
  • Excel in CIT operational efficiency measured by meeting or exceeding national benchmarks in operating expense PMPM costs by leveraging technology, data, lean processes, and delegation services where appropriate.

Strategic Responsibilities:

  • Strategy: develop, socialize, and implement clinical program strategy on a page with the capability of identifying short-term and long-term vision and goals in partnership and collaboration with leadership, operational leaders, clinical leaders, IT, population health, and analytics.
  • Assessment: develop a framework to assess CIT operations, clinical program measurement and performance, and effectiveness from patients’ and clinicians’ perspectives.
  • Governance and Prioritization: the ability to prioritize work by the organization’s goals and priorities. Relationship management and negotiation skills to ensure clinicians and market leaders feel engaged and respected in CIT and clinical program-related decision-making by partnering with the market and national leaders, developing feedback forums, and creating closed-loop communication channels with stakeholders. Share learnings with other Divisional Directors to standardize national processes to leverage scale.

Operational Responsibilities:

  • People: drive CIT to perform and focus on the organization’s priority efforts—building relationships with market dyads at both divisional and market levels. Empower and enable people leaders within the organization.
  • Process and Workflows: work with national leadership to standardize the process while also having the ability to partner with center operations and process teams to leverage lean methodology, swim lane diagrams to align on clear roles and responsibilities, and develop ways to improve operating PMPM costs
  • Technology: the ability to work with EMR, knowledge of care management tools, care management assessments, and documentation, and how information can be transformed into data to provide information about program performance management.

Required Qualifications:

  • Five or more years of management experience
  • Current and unrestricted US medical or RN license
  • Excellent verbal and written communication skills
  • Demonstrate a high level of skill with interpersonal relationships and communications with colleagues.
  • Experience in value-based care models (e.g. ACOs, capitation, shared-savings programs, bundled payments)
  • Willingness and ability to learn/adapt to practice in a value-based care setting
  • General familiarity with cost of specialty care, clinical outcomes measures, and avoidable hospitalization conditions
  • Basic computer skills, including email and EMR.
  • Characteristics of the qualified candidate:
    • A highly credible leader with deep understanding and empathy for the clinician and patient pain points in day-to-day panel management.
    • Excellence communication skills, including follow-through communication, executive presentations, and the ability to negotiate with horizontal and upward/downward vertical networks
    • Capable of developing and socializing a strategic plan with all key strategic components, including SMART goals or OKR framework
    • A passionate advocate for improving clinician and patient experience and effectiveness through panel management (aka population health management)
    • Comfortable managing influence in the context of multiple operations, development, and deployment initiatives in a matrixed environment

Year-One Critical Success Factors:

  • Promote a team-based approach with excellent relationships with market leaders (operations and clinical), including, but not limited to, having consistent and standardized program workflows, dyad communication/partnership, and quarterly business review of acute care and post-acute care utilization.
  • Engage with divisional and market dyads to build a strong relationship on identifying drivers and solutions/strategies for reducing acute and post-acute care utilization.
  • Establish and report findings every quarter of a scorecard with CIT key performance indicators that align with the PCO’s short- and long-term goals.

Use your skills to make an impact

Additional Information

Reporting Relationships:

  • Executive Vice President, National Clinical Innovation Officer

Other Key Relationships:

  • Division CMO
  • Division Ops Leaders
  • Division CIT Directors, CIT BH, and Pharmacy Directors, CIT Team Strategy Team Lead
  • Market President
  • Market CMO
  • Regional Medical Directors
  • VP CIO Care Delivery
  • VP, Clinical Excellence

 

Scheduled Weekly Hours

 

40

About us

About CenterWell Senior Primary Care: CenterWell Senior Primary Care provides proactive, preventive care to seniors, including wellness visits, physical exams, chronic condition management, screenings, minor injury treatment and more. Our unique care model focuses on personalized experiences, taking time to listen, learn and address the factors that impact patient well-being. Our integrated care teams, which include physicians, nurses, behavioral health specialists and more, spend up to 50 percent more time with patients, providing compassionate, personalized care that brings better health outcomes. We go beyond physical health by also addressing other factors that can impact a patient’s well-being.

 

About CenterWell, a Humana company: CenterWell creates experiences that put patients at the center. As the nation’s largest provider of senior-focused primary care, one of the largest providers of home health services, and fourth largest pharmacy benefit manager, CenterWell is focused on whole-person health by addressing the physical, emotional and social wellness of our patients. As part of Humana Inc. (NYSE: HUM), CenterWell offers stability, industry-leading benefits, and opportunities to grow yourself and your career. We proudly employ more than 30,000 clinicians who are committed to putting health first – for our teammates, patients, communities and company. By providing flexible scheduling options, clinical certifications, leadership development programs and career coaching, we allow employees to invest in their personal and professional well-being, all from day one.

Equal Opportunity Employer

 

It is the policy of  Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or because he or she is a protected veteran. It is also the policy of  Humana to take affirmative action to employ and to advance in employment, all persons regardless of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.