Vice President of Care Management

Description

Are you searching for a fulfilling role that can make a significant difference in healthcare?

At Innovista, we're devoted to driving transformative change in this essential sector. Our independent physician partners achieve exceptional results in every aspect of value-based care, contributing to enhanced patient care and improved practice outcomes. Innovista Health is a full-service management services organization with a commitment to revolutionizing practice, offering solutions like multi-payer program administration, quality, utilization, and care coordination services, as well as performance improvement insights and reporting.

Innovista Health Solutions, based in Illinois, is an organization with a far-reaching influence, operating in both Illinois and Texas. At Innovista, we trust in the power of innovative programs and dedicated people to propel us forward in today's ever-changing healthcare market.

This hybrid role, a blend of remote and onsite work, offers the chance to be part of our exciting journey towards a better, more efficient healthcare system. If you're based in the Illinois or Texas area, we'd love to hear from you!

Job Summary

The VP, Care Management is responsible for refining and optimizing the vision, strategy, and digital roadmap to reflect evolving Innovista needs, industry trends, and best practices. This role will have oversight of cost efficiency improvement of care management. This role is highly collaborative and requires strong partnership with leadership across multiple operational areas and plays a defining role in championing and advancing Innovista’s goal of delivering best in class consumer, patient, family, and provider experience.

This role is responsible for the oversight, design and implementation of new models of care that are essential to success in a transformed healthcare environment, ensuring health equity and social determinants are considered throughout the clinical program development The Vice President, Care Management will work closely with other clinical leads in the market, including Quality, Risk Adjustment and operations to manage utilization, improve patient outcomes , and maximize revenue. The leader will deliver on key principles of clinical innovation - building collaborative relationships and cohesive partnerships, with both internal and external stakeholders. The focus is on those elements necessary for success in a healthcare ecosystem that is in transition from fee-for-service to value-based care and alternative venues of care.

Duties And Responsibilities

• Leads the development and execution of strategies for Population Health, including innovative approaches to the delivery of care management that is aligned across markets (market operation standardization).
• Participates in efforts to increase the value of care through care management and clinical integration, including the patient-centered medical home, risk prediction strategies, population health analytics, and evaluation of related IT and services.
• Develops and implements strategy directed towards reducing ADK, readmissions and inappropriate ER Utilization.
• Oversees the development of program and clinical outcomes measures. This role will be a driver in expanding the use of empirical methods including measurement-based care to assess clinical effectiveness for improved outcomes and care delivery.
• Collaborates with leadership (COO and CFO) in maintaining fiscal responsibility for departmental operations.
• Ensures adequate staffing and service levels and maintains client satisfaction by implementing and monitoring staff productivity and performance indicators.
• Collaborates with technology and product teams to identify, implement, and optimize the use of digital and technological strategies to maximize member outreach, education, and care gap closures.
• Launches, refines, and optimizes the digital execution model, ensuring change management and high performance across collaborating departments if needed.
• Develops new paradigms of care that align with incentives.
• Collaborates with analytics departments to develop and enhance reports which demonstrate the effectiveness/ROI of clinical programs.
• In conjunction with Quality Improvement leadership, facilitates all aspects of the clinical quality improvement projects and reporting, including oversight and collection of data mandated for quality studies; evaluation of workflows to identify opportunities to improve productivity and maximize efficiency; and identification of trends and implementation of interventions as needed to improve clinical performance.
• Ensures that populations are screened for SDoH (social determinants of health) variables, and linking members with needs to appropriate CBOs (community-based organizations) as part of the core clinical programs.
• Continuously communicates with community partners and clients to support collaborations and cross-organizational efforts that the clinical and service teams are participating in.
• Other duties as assigned.
  
  

Requirements

• Bachelor of Science Degree in Nursing required.
• Current, active, and unrestricted nursing licensure in relevant states.
• Minimum of 15 years of progressive and broad senior leadership experience.
• CCM certification (preferred)
• Experience collaborating closely and/or leading cross-functional teams while driving metrics and business outcomes.
• Passion to drive better patient health outcomes and grow new and innovative care models.
• Experience leading digital consumer experience transformation programs (preferred).
• Strong communication skills with clinical and non-clinical audiences.
• Strong fiscal and strategic management skills.
• Excellent organizational skills.
• Demonstrate effective verbal and written communication skills.
• Demonstrate analytic skills when problem solving.
• Proficient in MS Office Applications with emphasis on advanced MS Excel skills. and ability to learn department and job specific software systems.
• Demonstrate high attention to detail and a high degree of accuracy.
• Aligned with Innovista’s mission and values and promotes them internally and externally.
• Able to switch priorities in a positive and effective manner based on the needs of the company and team
• Able to effectively communicate technical concepts with team members and basic business concepts with team members and internal customers.
  
  

Benefits

We are committed to creating a culture where everyone feels important, welcomed, and included. We demonstrate this commitment by offering a comprehensive benefits package that fosters opportunities for growth and advancement and supports the physical, mental, and financial wellbeing of our team members.

HEALTH & WELLBEING

• A choice health coverage, including HMO and PPO, plus Flexible Spending Account (FSA) and Health Savings Account (HSA) options
• Dental and vision coverage
• Company-paid benefits (short- and long-term disability, employee life, and accidental death and dismemberment)
• Employee Assistance Program
• Discounts and perks on gym memberships, shopping, travel, recreation, and more
  
  

FINANCIAL GROWTH

• A yearly discretionary bonus
• 401(k) with a company match
• Rewarding employee referral bonuses
  
  

WORK/LIFE BALANCE

• Generous paid time off policy that increases with tenure
• Nine paid company holidays + three Diversity Days
• Paid Parental Leave (up to 6 weeks, subject to applicable waiting period)
  
  

JOB SATISFACTION & ADVANCEMENT

• Clear career advancement and growth pathways
• Continuous education opportunities
• Diversity, Equity & Inclusion Committee with various Business Resource Groups you can join
• Company-wide socials and gatherings
• "Dress for Your Day" policy
• An open-door policy that encourages direct communication with our CEO and upper management, fostering transparency and inclusivity in our work culture
  
  

Benefits may be subjected to an applicable waiting period.