Hospice Clinical Program Administrator

Date: Nov 23, 2022

Location: Rancho Cucamonga, CA, US

Company: Inland Empire Health Plans

Job Requisition ID: 8391 

 

Position Summary/Position

 

Under the direction of the Vice President, Hospital Relations, the Hospice Clinical Program Administrator oversees the ongoing development and monitoring of the Quality Hospice Network Program by supervising, evaluating, and coordinating various components including clinical quality, service standards and financial stewardship. Oversees the day-to-day hospice quality dashboard to assure accuracy and integrity from all internal and external sources. Works with internal departments and external stakeholders to ensure streamlined processes and practices are in place to provide an optimal end of life care experience for Members and increase overall quality for the hospice network.

Major Functions (Duties and Responsibilities)

 

1. Analyze Hospice Quality Network performance using quality, operational, and financial data, for companywide processes and performance.
2. Provide subject matter expertise and guidance to IEHP Audit team for the monitoring of hospice clinical records and internal IEHP activities to ensure that they are accurate, complete, and meet required standards in accordance with IEHP policy and regulatory bodies.
3. Develop and implement performance improvement activities to respond to hospice service issues and challenges and participates from time to time in programs relating to quality and service improvement.
4. Assure problems/grievances/service failures experienced by individual patients/families/or physicians/hospitals are addressed with hospices and vendors and are resolved promptly and satisfactorily.
5. Analyze customer service issues related to hospices to identify causes and works with hospices and providers to improve performance.
6. Assist with surveys and requests from regulatory bodies and intermediaries as directed by IEHP and internal stakeholders.
7. Ensure accuracy and integrity of key hospice operational dashboard and its internal and external sources and implements changes to the dashboard as needed.
8. Monitor utilization of resources by hospice patient for services related to the hospice diagnosis and not covered/paid by the hospice provider to assure cost effective delivery of services.
9. Collaborate with Vice President and other external and internal stakeholders to formulate and refine Hospice Strategy including but not limited to:
  a. Defining and refining Hospice Network expectations in the area of quality, experience and financial stewardship
  b. Establishing targets of quality and financial performance
  c. Standards of professional behavior that support IEHP Mission, Vision, and Values
  d. Educating referring providers/partners, internal and external, re utilization of the Quality Hospice Network
10. Analyze annually or as appropriate the Quality Hospice Network against quality attributes and financial stewardship expectations.
11. Partner with hospice agencies on performance improvement plans when warranted.
12. Collaborate with Utilization Management, Health Services, Quality, and Finance to evaluate hospice internal processes to ensure optimal efficiency and effectiveness.

Supervisory Responsibilities

Leading: Guides Others

Experience Qualifications

 

Six (6) or more years of administrative or leadership experience in hospice clinical operations, finance, quality, performance improvement or provider relations.

Preferred Experience

 

Palliative Care experience a plus. 

Education Qualifications

 

Bachelor’s degree from an accredited institution required.

Preferred Education

 

Master’s degree from an accredited institution preferred.

Professional Certification

 

Certification in Hospice and Palliative Care preferred.

HACP from CAHSAH, Certified Home Care and Hospice Executive from NAHC, Advanced Certified Hospice and Palliative Care Nurse from HPNA, or Advanced Certification in Hospice and Palliative Care from NASW recommended.

Professional Licenses

 

Possession of an active, unrestricted, and unencumbered Registered Nurse (RN) license issued by the California BRN required. Other active, unrestricted, and unencumbered related licenses and appropriate experience considered. 

Drivers License Required

Yes, must have a valid California Driver's license and valid automobile insurance. Must qualify and maintain driving record to drive company vehicles based on IEHP insurance standards of no more than three (3) points.

Knowledge Requirement

 

This position provides hospice operational and tactical/strategic information for the effective oversight of the Hospice Quality Network Program. Requires a strategic thinker with knowledge of hospice operations and administration to include clinical best practices, quality standards, financial structure, and state/federal regulations. Must possess strong knowledge of project management and cross organization coordination. Demonstrate understanding of department relationships and external partnerships to support Hospital Relations’ daily operations. 

Skills Requirement

 

Strong research and data analytic skills. Strong project management skills. Excellent verbal and written communication skills. Strong interpersonal skills. Good presentation skills. 

Abilities Requirement

 

Strategic thinker. Strong ability to translate data into meaningful and actionable information. Creative thinker- willing to seek novel solutions. Ability to form collaborative relationships with team members across the organization and with external partners. Ability to present to large groups, including internal and external audiences. Strong attention to detail.

Commitment to Team Culture

 

The IEHP Team environment requires a Team Member to participate in the IEHP Team Culture. A Team Member demonstrates support of the Culture by developing professional and effective working relationships that include elements of respect and cooperation with Team Members, Members and associates outside of our organization.

Working Conditions

 

Word processing and data entry involving computer keyboard and screens.

Work Model Location

Hybrid

Physical Requirements

Hearing: Conference Speakers/Video Calls/Radio Calls - FREQUENTLY
Hearing: In a group - FREQUENTLY
Hearing: One-on-One - FREQUENTLY
Communicate: Information/ideas verbally - FREQUENTLY
Near Visual Acuity - FREQUENTLY
Develop and maintain positive work relationships - CONSTANTLY
Perform complex and varied tasks - CONSTANTLY
Adaptability: rate of change in work location - FREQUENTLY
Lead/Influence Others - FREQUENTLY
Rapid Pace of work - CONSTANTLY
Control of work pace - CONSTANTLY
Pace of work with faster/slower work periods - FREQUENTLY
Problem Solving - FREQUENTLY
Memory - FREQUENTLY
Understand and follow direction - CONSTANTLY
Regular and reliable attendance - CONSTANTLY
Keyboarding: 10-Key - FREQUENTLY
Keyboarding: Touch-Screen - FREQUENTLY
Keyboarding: Traditional - CONSTANTLY
Sitting - CONSTANTLY
Indoors - FREQUENTLY
Lighting - CONSTANTLY

A reasonable salary expectation is between $91,000.00 and $116,022.40, based upon experience and internal equity.

Inland Empire Health Plan (IEHP) is the largest not-for-profit Medi-Cal and Medicare health plan in the Inland Empire. We are also one of the largest employers in the region, designated as “Great Place to Work.” With a provider network of more than 5,000 and a team of more than 3,000 employees, IEHP provides quality, accessible healthcare services to more than 1.5 million members. And our Mission, Vision, and Values help guide us in the development of innovative programs and the creation of an award-winning workplace. As the healthcare landscape is transformed, we’re ready to make a difference today and in the years to come. Join our Team and make a difference with us! IEHP offers a competitive salary and stellar benefit package with a value estimated at 35% of the annual salary, including medical, dental, vision, team bonus, and state pension plan.


Nearest Major Market: Riverside
Nearest Secondary Market: Los Angeles