Vice President OF Clinical Services

What you can expect! Find joy in serving others with IEHP! We welcome you to join us in “healing and inspiring the human spirit” and to pivot from a “job” opportunity to an authentic experience! Reporting to the Chief Medical Officer, the Vice President, Care Coordination & Care Management provides enterprise-level leadership, operational direction, and strategic advancements for core operational care coordination and care management functions. This role is accountable for ensuring IEHP members across all risk levels receive integrated, effective, efficient, and compliant care services that measurably improve health outcomes. The Vice President is responsible for operating across the continuum of care coordination and management, and is accountable for optimizing performance, regulatory compliance (including DSNP requirements), and member experience across all lines of business. This role’s scope includes, but is not limited to, the oversight of key functional areas such as care management, behavioral health, case management, transitions of care and discharge planning, Long-Term Services, and strong coordination with Enhanced Care Management requirements. This role would also be required to coordinate with key county partners as identified. The Vice President will also advance care management and coordination functions through modern, scalable techniques, including the thoughtful adoption and integration of AI tools and innovative care management technologies where applicable. This role will also drive system-wide strategic initiatives in collaboration with key business partners such as Hospital Relations, Network Management, Quality, Medical Management, Population Health & Care Initiatives, and Pharmacy. Commitment to Quality: The IEHP Team is committed to incorporate IEHP’s Quality Program goals including, but not limited to, HEDIS, CAHPS, and NCQA Accreditation. Perks Competitive salary State of the art fitness center on-site Medical Insurance with Dental and Vision Life, short-term, and long-term disability options Career advancement opportunities and professional development Wellness programs that promote a healthy work-life balance Flexible Spending Account – Health Care/Childcare CalPERS retirement 457(b) option with a contribution match Paid life insurance for employees Pet care insurance Education & Requirement Minimum of twelve (12) years progressively responsible experience in managed care setting that serves the Medicaid population and/or similar populations Eight (8) or more years of progressive healthcare leadership Strong clinical experience in multidisciplinary team collaboration in a Medi-Cal managed care environment, as well as proficiency in care management, behavioral health, birthing pathways, complex children and all associated workflows Proven leadership experience, mentoring, and developing a team at a leadership level Bachelor's degree in a related field from an accredited institution required Master's or Doctorate degree in a related field from an accredited institution preferred Certification by one (1) of the American Specialty Boards preferred Possession of an active, unrestricted, and unencumbered license issued by the appropriate state board in one of the following areas required: Registered Nurse (RN) license issued by the California BRN Social Services related field issued by the California Board of Behavioral Sciences required. (LCSW or LMFT preferred.) Physician Assistant license issued by the Physician Assistant Board of California Physician and Surgeon license or Osteopathic Physician and Surgeon license issued by either the Medical Board of California or Osteopathic Medical Board of California Key Qualifications Must have a valid California Driver’s license Comprehensive knowledge and in-depth understanding of: Care Coordination and Care Management requirements, including, but not limited to, its application to PHM, LTSS, HEDIS and CAHPs, CMS, DMHC and NCQA regulations in both the inpatient and outpatient settings Experience with implementing new innovative tools, such as AI, in relevant care settings Clinical workflows and interdisciplinary team models End-to-end understanding of member journeys, clinical pathways, and escalation mechanisms Organizational design, workforce planning, leadership development, and building high-performing teams Program requirements, reporting standards, audit expectations, and compliance risks for care coordination and care management Excellent oral and written communication skills. Excellent interpersonal skills, diplomacy, coaching and change management skills Good Microsoft applications skills (Word, Excel, and PowerPoint) Demonstrated problem solving and decision-making skills with ability to exercise initiative Demonstrated ability to lead teams and achieve successful outcomes and results while fostering a climate of engagement and employee satisfaction \ #J-18808-Ljbffr