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Vice President, Care Management Operations - Bilingual

Company: Navvis
Location: Miami
Posted on: January 25, 2023

Job Description:


As a Vice President, Care Management Operations you will:

--- Be leader in an innovative organization that is leading transformational change

--- Under the direction of the Senior Vice President of Client Operations provide strategic and operational direction to the interdisciplinary teams managing client value-based lives

--- Lead the development of a new population health initiative with a new health plan client by forming interdisciplinary teams, utilizing the Navvis Programs and workflows, supporting improved care coordination for patients and their families, helping them live their best lives

--- Ensure Programs and workflows are supporting excellent clinical outcomes, team member satisfaction, and financial goals and outcomes. Provide leadership identifying improved processes and workflows

--- Provide the day-to-day leadership for client operations and population health activities of the teams located in the Virtual Care Center, as well as in-market/in-clinic teams ensuring proper staff configuration, hours of operation, and cross coverage

--- Partner with other leaders throughout Navvis and our clients, collaboratively innovating to ensure there is a process of continual improvement driving outcomes for patients, families and improving our business results

--- Establish processes ensuring high quality, efficient and effective conversations, care team referrals, and documentation are occurring with patients, families, and the health plan

--- Lead and support quality and operational performance utilizing data driven measurement tools to ensure quality delivery of services and documentation of actions taken

--- Ensure there are effective and efficient work queues for our teams

--- Champion the development of a productivity measurement system and performance metrics, and manage the productivity of the client operations teams

--- Support the process to measure and report on quality assurance activities and results - both client staffed as well as Navvis staffed teams/workflows

--- Lead, support and contribute to routine clinical rounds/internal care conferences for the teams focused on learning, teaching, problem solving for difficult cases/situations

--- Ensure we are providing effective initial and ongoing training and education for our team members

--- Ensure the Virtual Care Center site meets all regulatory and safety requirements including emergency management policies and procedures

--- Responsible for the financial and operational performance of the Department as well as the Client Virtual Care Center

--- Lead/manage patient education material, processes and vendors

--- Ensure team members comply with all medical licensure and professional credentialing in any relevant state of operation

A Day in the Life:

--- Identify, assess, and inform the Executive Leadership of internal and external issues that affect the organization

--- Escalate customer issues/concerns/problems in a pro-active and timely manner within reporting structure

--- Works with Leadership on departmental workforce planning

--- Ensure the Virtual Care Center clinical operations department provides population surveillance with the proper hours of operation and cross coverage support

--- Lead and cultivate a team of clinicians and non-clinicians to include directors, managers, registered nurses working as RN Care Managers, advance nurse practitioners, physical therapists, behavioral health specialists, registered dieticians, pharmacists, quality assurance specialists, and care navigators/care coordination specialists

--- Perform other duties as assigned

What Success Looks Like in this Role:

--- Inspirational, highly visible senior leadership taking a team successfully through a rapidly changing, innovative environment

--- Being a leader of leaders, cultivating strong leadership abilities throughout your team

--- Facilitate and engage your team to find the best solutions to complex problems - meeting the unique needs of the patients and families we serve

--- Partnering collaboratively with key stakeholders across the client and Navvis effectively and efficiently to assure successful delivery on assigned areas of responsibility

--- Designing/creating effective and efficient processes and workflows for the team, improving the team engagement and championing those changes through the proper approval channels

--- Recognize risks proactively and utilize appropriate resources to develop mitigation strategies that minimize or prevent any negative operational impact

--- Excellent collaborative communication, time management, organizational, and prioritization skills and ability to balance multiple priorities

--- Willingness to proactively jump in and assist others


We are excited about you if you have these things:

--- Demonstrated leadership, building successful teams and leading a team through change

--- Demonstrated senior/executive leadership in population health management, particularly leading large multidisciplinary clinical teams

--- Demonstrated measurable results in population health management including things like improved quality, improved efficiency, improved financial outcomes (increased membership/attribution, reduced cost of care)

--- 5+ years operational leadership experience in care coordination/population health activities including experience leading a centralized and distributed care management/care coordination team utilizing telephony systems

--- 2+ years' experience in health plan case management, care management, and utilization review including NCQA certification/re-certification experience

--- Experience in the patient continuum of care and transitions of care processes: acute health care, post-acute-care, ambulatory care, physician practices, health plan case management processes, etc.

--- In-depth experience in developing and leading care coordination improvement and process improvement standards

--- Experience leading a quality assurance and continual process improvement programs and teams

--- Business management experience including operational and financial responsibility for managing a physical site/location

--- Experience developing and successfully managing within a budget

--- Understanding of healthcare economics and various lines of business (i.e., Medicare Fee-for-service; Medicare Advantage, Commercial, Managed Medicaid, Medicaid Fee-for-service, unfunded, etc.)

--- Knowledge of state and federal rules and regulations and accrediting bodies

--- Strong business acumen. Experience reading and understanding income statements, budgets, financial performance metrics

--- Skill in exercising a high degree of initiative, professionalism, judgment, and discretion

--- Superior verbal and written communication skills

--- Experience with EPIC

--- Experience with a population health/care coordination platform

--- Expertise in interpersonal relationships, organizational relations, and effective communication, negotiation, and conflict resolution skills are required

--- Previous management experience including responsibilities for hiring, training, assigning work and managing performance of all centralized and in-market teams

--- Bachelor's Degree required in clinical (RN, PT, Pharmacy, Social Work, or similar field) and/or business field of study

--- Master's Degree in clinical or business-related field

--- Must have a current, unrestricted clinical Puerto Rico license as either Advanced Practice Registered Nurse, Physician Assistant, RN, PT, Pharmacist, Social Worker, or similar clinical field

--- Bilingual in English and Spanish


Keywords: Navvis, Miami , Vice President, Care Management Operations - Bilingual, Other , Miami, Florida

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