RN Population Health Services Manager

Job Description

Job Description

SUMMARY

The RN, Population Health Services Manager possesses a clinical background and experience in population health practices and principles. This person will direct and manage the daily work of the multiple population health teams and support the implementation of new programs identified by Executive Leadership. Provides leadership for the development, deployment and optimization of population healthcare services by managing the Care Coordination department team comprised of, but not limited to, RNs, LVNs, Community Health Workers, Care Coordinators and Prescription Coordinators. Responsible for leading the team to ensure optimal care for priority patient populations. Responsible for achieving programmatic requirements with other entities and payors such as the National Committee for Quality Assurance (NCQA), Centers for Medicare and Medicaid Services (CMS), and Central California Alliance for Health (CCAH).

ESSENTIAL DUTIES AND RESPONSIBILITIES includes but not limited to the following:

• Manages personnel within the population health department including but not limited to interviewing, hiring, performance management, staff development, disciplinary action, etc.
• Manages the daily work of the population health department and supports implementation of new programs.
• Leads the population health department by demonstrating the capacity and expertise to operationalize best practice recommendations, system goals, and regulatory requirements.

• Coordinates activities with key staff and implements changes and interventions to achieve improvement targets.

• Communicates with the team and continually evaluates plans in keeping the departmental priorities and initiatives on track including program implementation and progress towards programmatic metric goals.

• Communicates and collaborates with multidisciplinary healthcare team members, emphasizing continuity of care, in an effort to reduce or eliminate fragmentation, duplication, and gaps in treatment plans.
• Provides clear, strategic, and operational direction to enhance the value of services provided to the patients, hospitals, and providers.

• Leads initiatives around value-based contracting and reimbursement systems to gain a comprehensive understanding of programmatic goals, metrics, and priorities in optimizing patient care.
• Executes on goals and develops improvement programs to target key areas in order to excel in quality metrics and utilization targets.
• Develops and maintains standards following best practices for population health workflows aligned with an integrated, cross disciplinary team.
• Develops and monitors population health performance standards which include key performance indicators and performance targets focusing on improving healthcare outcomes.
• Monitors metrics and benchmarks to drive improvement and raise awareness that promotes individual growth and collective improvements in care within the population health department as well as across the multidisciplinary team.

• Identifies baseline workflows and process gaps in order to make enhancement recommendations and implement change processes, through in-depth system knowledge.

• Performs individual and group competency assessments of clinical knowledge, workflow knowledge and systems skills and assists with motivating and teaching team to excel. This includes periodic review of employee chart documentation to ensure compliance to best practice and standards.

• Facilitates, plans, and leads recurring meetings with stakeholders and senior management.

• Develops and maintains a comprehensive education and training program for population health department, inclusive of case review and case studies.

• Furnishes reports providing analytics to allow providers to address the populations directly attributed to them and further provide better care, improve health, and lower costs.
• Regularly attends various meetings, conference calls and training seminars. Must be able to grasp the pertinence of the subject and re-deliver or train others on the topics related to population health and care coordination activities.
• Maintains awareness of regulations, keeping abreast of pending and or implemented changes.
• Maintains the strictest confidentiality in the areas of patient, employee and provider relations.

• Other duties as assigned.

SUPERVISORY RESPONSIBILITIES

Direct management responsibility of 30-35 clinical and non-clinical staff. Carries out management responsibilities in accordance with the organization's policies and applicable laws.

QUALIFICATIONS

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

• Excellent communication, interpersonal, and organizational skills
• Experience with Epic is required
• Creative, flexible and easily adapts to changing priorities
• Energetic, takes initiative and able to work in a team environment as well as autonomously when needed
• Exhibits a strong work ethic. This individual must be innovative, efficient, and results focused.
• Understanding of clinical program development and improvement, analytical problem solving, project management, and ability to positively influence others.
• Ability to navigate ambiguity with the aid of structured problem-solving techniques.
• Understanding of value-based payment systems such as CMS’s Primary Care First, Medicare Shared Savings Program, Merit-Based Payment System, etc.

EDUCATION/EXPERIENCE and SKILLS:

• Current CA RN license.
• Bachelors of Science in Nursing required.
• Master's degree in Nursing, Public Health, Healthcare Administration, or a relevant field preferred.
• Minimum of 5 years of related clinical experience, preferably in population health, ambulatory care, community public health, case or care management, coordinating care across multiple settings and with multiple providers
• Experience working with vulnerable populations (geriatrics, minorities, behavioral health).
• Skills:
  1. Excellent verbal and written communication skills.
  2. Excellent interpersonal, negotiation, and conflict resolution skills.
  3. Excellent organizational skills and attention to detail.
  4. Strong analytical and problem-solving skills.
  5. Ability to prioritize tasks and to delegate them when appropriate.
  6. Ability to act with integrity, professionalism, and confidentiality.
  7. Thorough knowledge of employment-related laws and regulations.

REQUIREMENTS :

• Valid CA Driver’s License and proof of auto insurance coverage required
• Offer is contingent upon a successful completion of a background check.

PREFERRED

Bilingual may be required at certain clinics or during certain shifts.

CONDITION OF EMPLOYMENT:

Proof of identity and legal authority to work in the U.S. is a condition of employment. Cypress Healthcare Partners/Salinas Valley Health Clinics will not sponsor applicants for work visas.

The range displayed on this job posting reflects the target for new hire salaries for this position.