Job Description

Employment Type:

Full time Shift:

Day Shift
Description: At Saint Alphonsus Health System, we are looking for people who are living out their calling. We want you to be passionate about coming to work, and challenged to achieve your potential. Living by these virtues, we pride ourselves on exceptional service and the highest quality of care.

GENERAL SUMMARY AND PURPOSE:

The Director of the Alliance Clinical Team (ACT) will have direct and significant influence on defining and implementing the care management and population health strategies and initiatives of the Saint Alphonsus Health Alliance (Alliance) and its participating providers.

The Director, ACT is responsible for developing and implementing a comprehensive, multi-disciplinary care management model that will both support the Quadruple Aim and position the Alliance to deliver upon its Advance Payment Model (APM) payer contracts.

The Director, ACT will lead the development and execution of all SAHA care management programs and will ensure that these programs are designed to support the management of complex health conditions, encourage appropriate resource utilization, and facilitate effective patient self-care.

In this regard, the Director, ACT will interface and collaborate with the leadership of a broad network of employed and independent physician practices, hospitals, clinics, post-acute providers (e.g. SNF, LTAC, and Home Health), ancillary providers, and community-based service organizations to facilitate effective care management and coordination across patients\' continua of care. Further, the Director, ACT will serve as System Office\'s primary point of contact in the Alliance for matters related to care management and population health related matters (e.g. planning; initiatives; reporting; etc.).

The Director, ACT collaborates with appropriate Saint Alphonsus Health System (e.g. case managers, etc.) and Saint Alphonsus Medical Group (e.g. Director of Quality, etc.) colleagues to ensure that case/care/population health management activities are aligned, complementary, and not unnecessarily duplicative.

The Director, ACT will lead and/or participate in multi-disciplinary activities related to healthcare process and quality improvement. Further, the Director, ACT will be responsible for identifying and acting upon opportunities to improve ACT team performance through data and systems analysis.

The Director, ACT will work collaboratively with SAHA Contracting and Operations leads to develop direct-to-employer case and care management strategies, including but not limited to: targeted care management, transitions of care (TOC), disease management, patient outreach, and network navigation.

The Director, ACT will work closely with identified employer groups, TPAs, and consultants to develop and execute comprehensive patient care management strategies. This includes tracking, monitoring, and reporting applicable data.

On a daily basis, the Director, ACT, is responsible for providing leadership, management, direction, and support to ACT colleagues including licensed Nurse (RN) Care managers, licensed Social Workers (MSW/LCSW), non-licensed Community Health workers (CHWs), Administrative Care Management Coordinators, and other support staff.

The Director, ACT is responsible for: the direction of ACT team leads/supervisors, onboarding and orienting ACT colleagues, prioritizing and providing guidance in regard to the completion of ACT work, providing for the ongoing training and coaching of the ACT, monitoring ACT team performance and productivity, conveying ACT performance to SAHA, SAHS and Trinity Health leadership, holding ACT team members accountable for both team and individual performance, documenting and sharing established "best practices" with SAHA, SAHS and Trinity Health leadership, and collaborating with SAHA, SAHS and Trinity Health leadership to ensure that the ACT has the required resources to effectively and efficiently conduct their work.

The Director, ACT, is responsible for the development and monitoring of ACT processes and procedures, and ensures that these processes and procedures support maximal efficiency and productivity.

SKILLS, KNOWLEDGE, EDUCATION AND EXPERIENCE:

Colleague must have an RN license, as defined by their primary work state (Idaho or Oregon), issued prior to hire date. Those colleagues hired before November 1, 2019 must provide licensure in their secondary state within six months of November 1, 2019. Individuals hired in this role after November 1, 2019, must provide licensure in their secondary state within six months of hire.

Colleague will ensure he/she does not perform nursing care in the secondary state until the secondary licensure is received and properly documented by SAHS Human Resources Department. Bachelor\'s Degree or higher in Nursing or equivalent field required, master\'s degree preferred.

Minimum of 5 years of nursing experience required. Minimum of 5 years of experience in a complex and dynamic healthcare setting.

Minimum of 3 years care and/or case Management experience required; Care and Case Management certification (CCM, RN-BC) preferred. Minimum of 3 years of management experience required.

Minimum of 3 years of experience working with independent or employed physicians. Knowledge of risk-based contracting and/or payer experience preferred.

ESSENTIAL FUNCTIONS:

Knows, understands, incorporates, and demonstrates the Organization\'s Mission, Vision, and Values in behaviors, practices, and decisions. Serves as the ACT\'s primary point of contact to System Office. Translates relevant System Office initiatives and/or directives into Alliance clinical operations.

Provides direction, leadership, and oversight for all ACT programs to ensure that these programs are designed to support the management of complex health conditions, encourage appropriate resource utilization, and facilitate effective patient self-care. Develops and monitors ACT processes and procedures, and ensures that these processes and procedures support maximal efficiency and productivity.

Drives ACT operational improvement initiatives to in a manner that contributes to long-term Alliance operational and financial excellence. Effectively measures, monitors and communicates the impact of initiatives on Alliance performance. Develops, inspires, and maintains an effective, visible, and well-respected team by selecting, evaluating, developing, coaching, and managing the performance of qualified professionals.

Effectively leads a diverse team of colleagues with different skill sets and areas of expertise. Facilitates and manages team performance and efficiency to the established performance levels. Provides coaching to ACT team members and implements corrective action plans as necessary.

Promotes team and personal professional development through participation in departmental meetings, in-service programs, community programs and patient care committees. Accurately develops and effectively oversees ACT budgets. Ensures for the accuracy of ACT payroll information. Collaborates with ACT colleagues, patients, providers, and other stakeholders to ensure desired care management and population health outcomes are met.

Utilizes analytic skills to interpret data, direct improvement efforts and share key information with leaders and physicians/providers. Uses evidence-based tools to identify and address patient needs. Communicates clearly, effectively and collaboratively in a manner. Delivers key initiatives on time, within budget, and according to established plans.

Ensures compliance with all regulatory requirements. Other responsibilities as assigned by the Alliance President or Executive Medical Director. Proactive leader with the proven ability to realize an ambitious vision. Successful influencer who can effectively engage diverse groups of stakeholders, including providers, health care administrators, payers, and the inter-professional team. Demonstrated leader with a track record for managing diverse and dynamic teams.

Motivator who sets and achieves high standards of performance in a collegial environment. Motivator who effectively holds self and others accountable for realizing high levels of performance. Experience with major clinical IT platforms, and fluent with complex electronic medical record vendor platforms and corresponding successful data extraction.

Strong computer skills with including a working knowledge of clinical data and informatics, including payer claims, reporting and documentation platforms. Demonstrates an understanding of disease processes, clinical rationale, medical findings, and expected outcomes. Strong interpersonal and communication skills, both verbal & written. Independent problem solving and decision-making abilities. High tolerance for complex, ambiguous and constantly changing environment.

Our Commitment to Diversity and Inclusion

Trinity Health is a family of 115,000 colleagues and nearly 26,000 physicians and clinicians across 25 states. Because we serve diverse populations, our colleagues are trained to recognize the cultural beliefs, values, traditions, language preferences, and health practices of the communities that we serve and to apply that knowledge to produce positive health outcomes. We also recognize that each of us has a different way of thinking and perceiving our world and that these differences often lead to innovative solutions.

Our dedication to diversity includes a unified workforce (through training and education, recruitment, retention, and development), commitment and accountability, communication . click apply for full job details

Saint Alphonsus Health System