Clinical Care Program Director-Medicare Stars

Job ID: J128834
Company: Gateway Health Plan
Location: Pittsburgh, PA, United States
Full/Part Time: Full time
Job Type: Regular
Posted at: Aug 20, 2018

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Description

JOB SUMMARY

This job is responsible for the overall operations of a Clinical Care Program.  Ensures the establishment and attainment of tactical and operational goals consistent with the organizational strategic plan, and in accordance with budgetary, quality and service excellence goals; represents the Program to internal and external constituents so as to promote a positive image of the program.  Works collaboratively with administration, physicians and care teams to facilitate the implementation of the Team Based Care model of care and care management programs. Develops and implements strategies to promote the principles of value based care delivery and goals.

ESSENTIAL RESPONSIBILITIES

  • Actively participate in the strategic planning process by establishing strategic direction and prioritizing of strategic initiatives. Assist in the development of short and long range institutional goals in accordance with the organization's mission, vision, values and strategic direction.
  • Facilitate implementation of replicable best practice workflows and standard operating procedures to optimize performance on Program goals.
  • Prepare and manage according to fiscal year budget plans, ensuring that the budget planning process correctly identifies operational needs of the Program and operates within the approved fiscal year budget.
  • Provide oversight and leadership of the Program to ensure that all quality standards and all other regulatory requirements are met on a continuous basis within the established parameters and scope.
  • Provide leadership to staff ensuring hiring, development and retention of key staff and the creation/maintenance of a high quality service and high performing work teams.
  • Manage/measure progress of Program initiatives and corresponding goals. Effectively communicate to all involved parties and leaders.
  • Develop and implement quality improvement strategies with the care teams. Continually assess workflow and workflow redesign to optimize patient and program outcomes.
  • Other duties as assigned.

EDUCATION

Required

  • Bachelor's Degree in Business Administration/Management, Nursing, Social Work or Health Administration

Substitutions

  • None

Preferred

  • Master's Degree in Business Administration/Management, Nursing, Social Work or Health Administration

EXPERIENCE

Required

  • 10 - 15 years of Clinical Services experience
  • 3 - 5 years of direct Patient Care Industry experience
  • 3 - 5 years of Leadership experience
  • 3 - 5 years of Primary Care Delivery Systems experience
  • 3 - 5 years or Provider Communications experience

Preferred

  • 3 - 5 years of Operational Excellence experience
  • 3 - 5 years of Cross-Functional Project Team experience
  • 3 - 5 years of Operational Excellence experience
  • 3 - 5 years of Program Management experience
  • 3 - 5 years of Quality Improvement experience

LICENSES or CERTIFICATIONS

Required

  • None

Preferred

  • None

SKILLS

  • Analytical and Logical Reasoning/Thinking
  • Articulate Communicator
  • Building and Leading Teams
  • Change Management
  • Collaborative Problem Solving
  • Critical Thinking
  • Leading Organizational Vision
  • Operational Planning
  • Process Optimization
  • Tolerance for Ambiguity

Language Requirement (other than English)

None

Travel Required

25% - 50%

PHYSICAL, MENTAL DEMANDS AND WORKING CONDITIONS

Position Type

Office-Based

Teaches/trains others regularly

Frequently

Travel regularly from the office to various work sites or from site-to-site

Never

Works primarily out-of-the-office selling products/services (sales employees)

Never

Physical work site required

Yes

Lifting: up to 10 pounds

Rarely

Lifting: 10 to 25 pounds

Does Not Apply

Lifting: 25 to 50 pounds

Does Not Apply

Disclaimer: The job description has been designed to indicate the general nature and essential duties and responsibilities of work performed by employees within this job title. It may not contain a comprehensive inventory of all duties, responsibilities, and qualifications required of employees to do this job.

Compliance Requirement: This position adheres to the ethical and legal standards and behavioral expectations as set forth in the code of business conduct and company policies

Highmark Health and its affiliates prohibit discrimination against qualified individuals based on their status as protected veterans or individuals with disabilities, and prohibit discrimination against all individuals based on their race, color, religion, sex, national origin, sexual orientation/gender identity or any other category protected by applicable federal, state or local law. Highmark Health and its affiliates take affirmative action to employ and advance in employment individuals without regard to race, color, religion, sex, national origin, sexual orientation/gender identity, protected veteran status or disability.
EEO is The Law
Equal Opportunity Employer Minorities/Women/ProtectedVeterans/Disabled/Sexual Orientation/Gender Identity (http://www1.eeoc.gov/employers/upload/eeoc_self_print_poster.pdf)
We endeavor to make this site accessible to any and all users. If you would like to contact us regarding the accessibility of our website or need assistance completing the application process, please contact number below.
For accommodation requests, please call HR Services at 844-242-HR4U or visit HR Services Online at HRServices@highmarkhealth.org

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