Executive Vice President (Case Management Population Health Officer)
Job (Pay Plan) Title: Executive Vice President
Working Title: Care Management Population Health Officer
Name of Employee: Vacant
FLSA Status: Exempt
Position Number: 80122
Cost Center/Department: 85/MHSU Care Coordination
Care Management and Population Health Officer leads the organization Care Management and Population Health division from an enterprise lens including consideration for organizational design, program and product implementation, monitoring and assessment of care management and population health strategic plans and initiatives across Trillium Health Resources.
Trillium Health Resources works to build vibrant, culturally appropriate and inclusive service care management and population health delivery systems and networks for care. Intentional strategy, robustly monitored and evaluated, plays a critical role in ensuring that Trillium Health Resources’ considerable resources are deployed to greatest impact and our mission to create an integrated care approach for our members can be met. Trillium is currently undergoing a period of transformation with the ambition of positioning the organization as a BH IDD Tailored plan that will be viable long term as a solution for BH-I/DD populations in the state. The Care Management Population Health Officer plays an integral role in this effort, ensuring that Trillium’s member, provider and stakeholder strategies are rigorously shaped and informed at the organizational level while being contractually aligned, and judiciously evaluated to meet the challenges of the present and future.
The Care Management and Population Health Officer reports to the Chief Medical Officer (CMO), and acts as a thought partner to all programs, units and departments involved in strategy and initiatives of the organization. The position plays a critical role in ensuring that Trillium Health Resources becomes increasingly outcomes focused in navigating strategic planning, and incorporates a highly cogent analysis of political climates, social trends and other industry factors in defining how strategy can be shaped for success. The Care Management and Population Health Officer acts as principal counsel to internal and external stakeholders on design and evaluation.
This position also provides leadership and oversight for the assigned functional areas of Trillium Health Resources. This position is responsible for the management of Unit Directors and senior level Department heads in the development of key performance indicators that are used to monitor the health of the agency and its progress in meeting its goals.
Essential Duties and Responsibilities:
1. Leads the development of the Care Management and Population Health division of Trillium, including articulating a critical evaluation metrics of for population health across the organization;
2. Facilitates the execution of Care Management Population health goals by working collaboratively with the other Executive and Leadership Team members and ensuring that Care Management and Population Health goals are clearly established and communicated and easily understood by all throughout the organization.
3. Acts as a key advisor to the Chief Medical Officer on critical changes in the competitive landscape, internal capacity and organizational design and external environment.
4. Works in partnership with the Chief Executive Officer and Executive Team on processes to identify opportunities and pressure test ideas that support the long-term organizational strategy and cost effective operations.
5. Advances Trillium’s goal to scale access to unmet health related resources that impact health in marginalized communities and covered populations through staff education and supervision and advising on care gaps to support an enterprise approach to removing barriers for clinical providers and maximizing payment models in Medicaid and State funding.
6. Engages external industry experts to learn and influence business strategies, constantly remaining alert and forward-thinking about opportunities and risks in the industry.
7. Leads the development and implementation of consistent practices and strategic frameworks across Trillium that improve member care and experience and that of community stakeholders.
8. Creates success measures and organizational dashboards and tools to communicate progress toward goals for impact and organizational effectiveness.
9. Communicates and implements Trillium’s strategy internally and externally so that all employees, providers and community stakeholders understand the Care Management and Population Health approach and how it carries out the overall goals.
10. Acts as a resource across the organization to increase broad cohesion for strategic goals for Care Management and Population Health.
11. Bring thought leadership to organizational strategic alignment; act as a principal resource in the development and implementation of Care Management and Population Health approaches and tools that center organizational effectiveness; enable programs to take full advantage of all Trillium assets at their disposal;
12. Oversees the assigned areas of operations. This includes recruitment and performance management of staff as well as overseeing programs and projects identified to meet the goals of the BH I/DD Tailored plan.
13. Determine the strategy and scope of the work, responsible departments and teams, and defined outcomes/deliverables. Monitor implementation of the plan, and/or coordinate revisions to reflect changes in goals and priorities. Implement a system of Standard Operating Procedures that are used to consistently direct the work of the agency and that are used to inform consumer and provider educational materials.
14. Ensures that programs are monitored and reviewed for compliance. Ensures that cross-area planning and implementation of activities in the areas of quality and compliance occur. Maintain national accreditation from an appropriate entity as related to managed care functionality.
15. Assists in developing goals and strategies that are aligned with the mission of the BH I/DD Tailored plan.
16. Oversee, plan and implement quality checks for projects and overall implementation across the assigned teams to deliver high quality care and functional output. Also ensure effective and ongoing training, evaluation, coaching and counseling to staff members and stakeholders.
17. Conduct public relations activities with high profile stakeholders, as required to assist the CEO, who has primary responsibility with high profile stakeholders and elected officials.
18. Represents CEO and Trillium by involvement in state, regional, community programs and inter-agency conferences and meetings. Establishes and maintains effective relationships with agency personnel, county and state officials and the general public.
19. Keeps current on legislation and makes recommendations for changes when necessary. Develops policies as required by the CEO for approval by the Board.
20. Other duties as assigned.
This position supervises the Care Management and Population Health departments in the agency
Education: Master’s Degree in a Human Services field required. Prefer Nursing degree.
Experience: Eight(8-) plus years’ progressive experience including six (6-) years supervisory experience at an Executive or Senior management level and including a minimum five (5) years of demonstrated care management/population health experience in a healthcare organization serving Medicaid beneficiaries including experience with BH and IDD populations required.
Preference will be given for:
• Four (4) years of experience in managed care organization/environment.
• Demonstrated leadership skills through both internal and external leadership roles.
• Excellent public speaking skills.
• Knowledge and experience with multiple funding streams and demonstrate experience to manage benefits for members.
• Six sigma training and capacity to lead meetings using six sigma methodology.
• Diverse experience with all populations covered by agency.
• Extensive knowledge of advancing technological applications.
• Experience in implementation and transforming systems and processes related to integrated care.
License/Certification: NC fully licensed clinician. Preference for Nursing License
Location: Must reside in NC
Knowledge, Skills and Abilities: The employee must be a skilled administrator. The employee must be able to exercise excellent judgment in assessing situations and advising and supporting Executive staff with complex problems. Judgment and discretion must also be exercised in the application and interpretation of complex rules, regulations, clinical guidelines, standards, and procedures. The employee must be able to read and understand complex written materials as well as to comprehend and retain complex spoken information. Excellent written and oral communication skills are required. The employee must be able to establish and maintain effective working relationships with consumers and families, staff, departments within the agency, and community stakeholders including advocacy groups, associates, officials, and the public. Diplomacy is required in all such interactions. The employee must demonstrate excellent negotiation skills in working with teams, providers, and other departments to resolve issues of concern.
The employee must have strong administrative skills in order to coordinate the scope of activities, staff and providers under the management of the agency.
The employee must be knowledgeable of the field of MH/DD/SA and in the best practices for the supports and treatment of consumers.
The employee must be competent in the complex funding system and regulatory environment that is under local management, including accountability to the state Mental Health and Medicaid agencies.
The employee must be extremely organized and able to organize the work of others
Decision Making/Consequences of Error: All decisions must be well researched in order to ensure that critical information has been considered. Consideration of complex data, feedback and information, consumer impact, political impact, is required for decisions and the development of appropriate courses of actions to solve problems and for pro-active planning. The employee must demonstrate extreme accuracy in identification of key information needed to address problems. It is critical that public relations activities be handled in an appropriate manner in order to maintain public understanding and enlist support for Trillium efforts to manage a local/regional system of care. Errors in implementing state and federal requirements for services and documentation could result in paybacks or loss of accreditation and/or funding to the agency. Failure to follow procedures and requirements regarding finance and documentation could result in out of compliance audit findings. Failure to follow personnel, risk management, staff training and other requirements could also result in an event resulting in liability to the agency
Nature and Purpose of Pubic Contacts: Personal contacts are a significant factor in the employee’s effective performance of job duties. The employee must be able to communicate effectively, both verbally and in written form, with employees, staff, local agencies and officials, advocates, parents, and individuals receiving services. It is essential that the employee have a sincere dedication to the needs of consumers. The employee must communicate in a positive and caring manner in order to convey the agency’s concern for the needs of people needing MH/DD/SA treatment and services. Employee must be able to be supportive of staff that report to the Deputy Director and to be able to provide assistance to them in the performance of their duties. The employee must be well educated in cultural diversity issues and sensitive in interactions with various and diverse members of the staff and community. This includes being able to convey criticism in a positive and encouraging manner and promoting optimal performance of employees.
Mental /Physical Demands: All work requires close mental attention. Position may have interruptions periodically. Position must meet funding source deadlines as required by funding sources. Some travel is required. Mild tasks with some physical effort. Performance requires sitting, intermittent standing/walking/stooping/bending. Finger/hand/arm movement required. Position may be very stressful at times with multiple project deadlines.
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