Director of Special Projects

Company: Health Plan of San Joaquin
Position: Director of Special Projects
Reports to: Chief Medical Officer
Location: French Camp, CA

Job Description: Health Plan of San Joaquin has retained Morgan Consulting Resources, Inc. to conduct the search for their Director of Special Projects position based in French Camp, California. This is a fantastic opportunity to join the successful and growing Medi-Cal plan serving two counties in the Central Valley of California with nearly 350,000 members.

About the Organization:

  • Serving California’s Central Valley since 1996, Health Plan of San Joaquin <x{(}>(</x{(}>HPSJ) is a publicly sponsored, not-for-profit HMO with a contract with the California Department of Health Care Services<x{(}>(</x{(}>DHCS) to manage health care for Medi-Cal members.
  • HPSJ provides compassionate, high-quality care through their collaboration with hundreds of Primary Care Physicians, all area hospitals, thousands of specialists, and the majority of pharmacies within San Joaquin and Stanislaus counties.
  • HPSJ has among the highest enrollee plan selection rates <x{(}>(</x{(}>91%) of any California-based Medicaid plan.
  • HPSJ is one of only twelve California health plans with NCQA Accreditation for a managed care Medi-Cal program.
  • HPSJ was recognized by the National Commonwealth Fund in 2017 for the Health Plan’s influence in regional health improvements realized through collaboration and capacity building.
  • HPSJ was awarded both planning and implementation grants from the California Health Care Foundation to reduce opioid dependency – a collaborative effort with San Joaquin General Hospital and Community Medical Center.
  • HPSJ partnered with San Joaquin General Hospital and two hospice agencies to launch a community outpatient Palliative Care program providing integrated, patient and family centered care for patients facing life-threatening health conditions.
  • You can learn more about HPSJ by visiting their website at https://www.hpsj.com/.

About the Position:

Reporting to the Chief Medical Officer, the Director of Special Projects is responsible for ensuring the medical management department adheres to new and existing regulatory requirements and overseeing the coordination of audit activities within the department. In addition, the Director will manage the planning, implementation and ongoing activities related to innovation grants awarded to medical management within the organization. This will require coordination between internal and external stakeholders, ensuring deliverables are met and preparing reports for grantees.

The ideal candidate will have strong project management skills, a solid understanding of medical management and experience with regulatory audits and compliance. The Director must have the ability to manage by influence, operate proactively and build effective relationships both internally and externally. S/he must thrive in a collaborative, team focused and highly accountable culture. Strong health plan experience is a must, preferably within Medicaid. The Director will serve as a key member of the CMO’s direct reports team and will be involved in projects that ensure regulatory compliance or new programs or projects that improve the care of the health plan members.

Essential Functions:

  • Leads research and development of special programs and projects as directed by the CMO.
  • Works with internal and external resources to develop financial models and feasibility analysis for new projects.
  • Defines project’s objective, scope and success measures in collaboration with CMO and directors.
  • Leads the identification and prioritization of special projects within Medical Management; oversees or manages project implementations.
  • Identifies, secures and manages, oversees or assists with the identification, securing and management of internal and external project resources.
  • Leads development, implementation and maintenance of best practice methodology, including but not limited to technology, policies, procedures, processes, tools and standards; ensures their dissemination and understanding among stakeholders.
  • Develops and manages, or oversees the development and management of department and project budgets.
  • Develops, implements and maintains, or oversees the development, implementation and maintenance of the appropriate and required data, records, reports, and other documentation.
  • Serves as the key content expert for the projects and ensures leadership for the projects from inception to implementation and evaluation.
  • Ensures Medical Management’s preparedness for and compliance with Regulatory changes and state audits and leads these activities through Matrix management.
  • Represents Medical Management and HPSJ in a manner that promotes a positive image of HPSJ in the community.
  • Serves on internal and external committees as needed.
  • Promotes and maintains an environment that supports HPSJ’s strategy, vision, mission and values.

Knowledge, Skills and Abilities

  • In-depth knowledge of the health care industry, its critical issues and major challenges.
  • In-depth knowledge of health care delivery systems.
  • Knowledge of managed care, including its products, services, major business functions and their interactions.
  • Knowledge of California Managed Medicaid regulatory requirements and NCQA accreditation requirements.
  • Financial acumen: Interprets and applies understanding of key financial indicators to make better business decisions.
  • Strong skills in budget development and management, with demonstrated ability to bring large, complex projects in on time and on budget.
  • Advanced assessment and analytical skills, including the ability to synthesize, distill concepts, draw conclusions and identify implications.
  • Manages complexity: Makes sense of complex, high quantity, and sometimes contradictory information to effectively solve problems.
  • Decision quality: Makes good and timely decisions that keep the organization moving forward.
  • Strategic mindset: Sees ahead to future possibilities and translates them into breakthrough strategies; creates, executes and monitors relevant strategic and business plans.
  • Resourcefulness: Secures and deploys resources effectively and efficiently; organizes people and resources to solve problems and identify opportunities.
  • Plans and aligns: Plans and prioritizes work for self and others to meet commitments aligned with organization goals.
  • Ensures accountability: Holds self and others accountable to meet commitments.
  • Drives results: Consistently achieves results, even under tough circumstances.
  • Strong interpersonal skills, including but not limited to the ability to establish and maintain effective working relationships with individuals at all levels both inside and outside of HPSJ.
  • Strong oral and written communication skills, including but not limited to the ability to communicate professionally to diverse individuals and groups inside and outside of HPSJ; includes presentations, with the ability to tailor presentations to a specific audience.
  • Advanced presentation skills, including but not limited to the ability to tailor presentations to a specific audience, be persuasive and identify key messages.
  • Strong collaboration skills, including but not limited to the ability to create and foster a collaborative work environment, and organize people and resources to solve problems and identify opportunities.
  • Builds networks: Effectively builds formal and informal relationship networks inside and outside of the organization.
  • Organizational savvy: Maneuvers comfortably through complex policy, process and people-related organizational dynamics.
  • Persuades: Uses compelling arguments to gain the support and commitment of others.
  • Manages ambiguity: Operates effectively, even when things are not certain or the way forward is not clear.
  • Strong knowledge of change management theory, with ability to anticipate and implement effectively.
  • Demonstrated ability to articulate and support HPSJ’s vision, mission, values and strategy, integrate into management practices, and foster their manifestation among staff.
  • Expert knowledge of the principles and best practices of project management, including, but not limited to project life cycle, scope definition and management, planning and scheduling, monitoring, communication cycles, project team and risk management.
  • Ability to speak and be understood in English.
  • Ability to treat confidential information with appropriate discretion.

Education and Experience

Required:

  • Bachelor’s degree in Nursing, Bachelor’s degree in Business or similar; and
  • At least five years’ experience in implementing various projects and audits; or
  • Equivalent combination of education and experience.

Preferred:

  • Experience in project management in healthcare and/or Medi-Cal/ Medicaid.
  • Master’s degree in Healthcare.
  • Strong understanding of the California healthcare landscape.

Licenses, Certifications:

  • Valid California driver’s license and reliable transportation or the ability to obtain transportation on demand if prohibited from getting a driver’s license due to a medically documented disability.
  • Project management certificate or equivalent experience.
  • Current unrestricted California RN license (if RN).

About French Camp:

French Camp, in California’s Central Valley, is a commutable distance from several locations in the Bay Area, Sacramento and surrounding areas. The community offers an excellent quality of life, affordable housing and easy access to a variety of outdoor activities, including Lake Tahoe and Yosemite National Park.

If you or someone you know has the qualifications we seek, I’d love to set up a time to talk. Thank you so much for your time.

Lisa Coyne, Principal
Morgan Consulting Resources, Inc.
lisa@morganconsulting.com

Position Description »