Central Director of Care Operations

At Diverge Health we are a team of entrepreneurs passionate about improving health access and outcomes for those most in need. We partner with primary care providers to improve the engagement and management of their Medicaid patients, providing independent practices access to specialized resources and clinical programs to address medical, social and behavioral patient needs. Our care ecosystem is equipped with enhanced technology and data interfaces to enable provider and patient success in a value-based environment. Guided by our core values of humility, continuous learning and feeling the weight, our team is on a mission to strengthen communities from within, unlocking people's ability to live their healthiest lives.

We are looking for a Director of Clinical Operations to join our team! As a pivotal part of our central team, you’ll be responsible for ensuring operational processes that enable our care model are deployed accurately, and continue to function over time. You will work across a diverse set of stakeholders both centrally and across each market. You will work closely with our Population Health, Operations, and Clinical teams, as well as our Market Presidents and local care teams. This role is crucial for providing operational excellence on how we engage with our patients and our network of primary care practices.

What You’ll Do

As a Director of Clinical Operations, you will set the Diverge enterprise strategy for Clinical Operations that is to be executed at the market level. You will work closely with market leadership and Care Teams to ensure that the infrastructure and operational processes to enable the Diverge Model of Care are being implemented appropriately across markets, while simultaneously being responsive to market feedback and working around market specific nuances.

Key Areas You’ll Add Value

• Design and deploy scalable operational processes that enable patient care and practice engagement including, but not limited to, processes for:
• Ensuring that data on eligible patients from new and existing sources are being activated in timely and streamlined ways such as:
• Coordinating with state specific HIEs, national data providers, and the Diverge Health technology function, to obtain lab values, admit, discharge & transfer (ADT) alerts, and other clinical data
• Collaborating with the Practice Liaison function to intake electronic medical record (EMR) extracts, and direct patient referrals from network practices
• Collaborating with the Payer Account Management function to intake claims and other payer data
• Routing patients identified through various data sources, and direct primary care physician (PCP) referrals, into Care Team workflows such as:
• Closing the loop between receipt of payor data, the performance of risk stratification, and the initiation of patient outreach by appropriate Care Team members in each market
• Integrating direct patient referrals from PCPs into patient outreach workflows
• Integrating ADT alerts, lab values, and other clinical data into patient outreach and practice notification workflows
• Integrating quality data into patient outreach and care management workflows in support of the enterprise quality strategy
• Facilitating bi-directional communication between Diverge Health Care Teams and network practices (both practice administrators and PCPs) for care coordination as well as more urgent patient issue escalations
• Transferring data, clinical documentation, and other information between Diverge Health and practice EMRs
• Deploy a centralized patient outreach function to generate a robust volume of interested patients for engagement by Diverge Health Care Teams
• Generate reporting on both process and outcome metrics for internal stakeholders, as well as payer clients and network practices
• Receive and process market feedback, understand when an overarching operational gap exist vs a market specific challenge
• Oversee the implementation and utilization of clinical information systems and technology
• Disseminate standard operating procedures (SOPs) related to Patient Outreach, ADT alerts, Care Team to practice communications, and proactive KPI monitoring to market leadership and staff
• Assess and document the logistic needs of Care Teams (space, supplies, field logistics & safety procedures), including proactively identifying needs that are not yet defined, and work with the appropriate market and functional leaders to address those needs
  
  

What You’ll Bring

• Experience working in a clinical setting
• Clinical experience (RN, NP, LPN, etc)
• 5-7 years of experience in clinical operations
• Ability to distill abstract concepts into concrete processes and steps
• Ability to operate in an everchanging environment
• Experience with process design and change management
• Understanding of population health management from the provider or payor vantage point
• Familiarity with consumer (patient and practice) engagement
• Familiarity with case management and population health best practices
• Familiarity with common EMRs such as Athena, Practice Fusion, Epic and eClinicalWorks
• Familiarity with Health Information Exchanges (HIEs)
• Ability to receive and implement constructive feedback
  
  

Preferred Experience

• Clinical training (e.g. Nurse Practitioner)
• Experience partnering with primary care physicians or working within a physician group
• Understanding of population health management from the provider and payor vantage point
  
  

Our Investors

Diverge Health is funded by GV and incubated by Triple Aim Partners, which since 2019 has partnered with entrepreneurs to co-found and launch eight companies focused on improving the quality, experience and total cost of healthcare.

At Diverge Health we believe that a diverse set of backgrounds and experiences enrich our teams and enable us to realize our mission. If you do not have experience in all areas detailed above, we encourage you to share your unique background with us and how it might be additive to our team.

Special Considerations

Diverge Health is dedicated to the principles of Diversity, Equity and Inclusion and Equal Employment Opportunities for all employees and applicants for employment. We do not discriminate on the basis of race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identify or expression, or any other characteristic protected by the federal, state or local laws. Our decision to hire, promote, discipline, or discharge, will be based on merit, competence, performance and business needs.