Manager, Clinical Programs - Hospital Relations

Date: Jul 26, 2022

Location: Rancho Cucamonga, CA, US

Company: Inland Empire Health Plans

Job Requisition ID: 7725 

 

Position Summary/Position

 

Reporting to the VP of Hospital Relations, the Manager, Clinical Programs - Hospital Relations will design and implement clinical programs, initiatives, and pilots to strategically advance IEHP strategic priorities and goals to improve quality to members, providers, and hospital partners.
In this role, the manager, clinical program will provide oversight of identified initiatives, including planning, organizing, and collaborating with key internal and external stakeholders.  In this role, the individual will be also ensuring the work is in line with IEHP strategic quality goals, objectives and is conducted and executed effectively.

Major Functions (Duties and Responsibilities)

 

1. Operate and guides others at a strategic business level to ensure initiatives, programs or pilots are in line with IEHP strategic goals that foster clinical care transformation.
2. Develop innovative solutions and optimization of services in collaboration with internal and external stakeholders (i.e. Hospital Partners, SNFs, PCPs, etc.) that are efficient and effective that better serve Members. 
3. Oversee all aspects of program operations: initiation, planning, development, and monitoring.
4. Participate in the research and selection process of vendors.
5. Track contract expectations, communication, budgets, performance metrics and timelines.
6. Responsible for issue resolution to mitigate enterprise risk.
7. Prepare, oversee, and review documents that are related to assigned clinical projects.
8. Consult with all levels of senior management, make recommendations, and influence decision making.
9. Evaluate the availability of necessary resources for the execution of hospital-related clinical projects.
10. Leverage cross functional relationships with vendors, hospital partners, external consultants and IEHP Team Members.
11. Collaborate closely with Quality and Compliance for alignment with data reporting and project compliance.
12. Determine key business issues including resolution; take part in procedure/process improvement initiatives.
13. Demonstrate thought leadership and cross functional collaboration within the IEHP environment.
14. Help in the training and development of staff, especially clinical staff, as needed.
15. Develop, review, analyze and interpret department and individual performance reports to ensure that the team is continually performing at optimum levels.

Major Functions (Duties and Responsibilities) Cont

Supervisory Responsibilities

Leader: Administers Hires, Terminations, and Performance Reviews

Experience Qualifications

 

Requires at least five (5) years of prior relevant experience. Requires at least three (3) years of experience in health plan or hospital setting. Experience in Quality improvement and utilization management.

Preferred Experience

 

Writing clinical procedures and other clinical documents is a plus.

Education Qualifications

 

Bachelor’s degree in any Science or Health Related field from an accredited institution required.

Preferred Education

 

Master’s degree in any Science or Health related field from an accredited institution preferred.

Professional Certification

 

PMP Certification Preferred 

Professional Licenses

 

Possession of an active, unrestricted, and unencumbered license issued by appropriate california state board required:
- RN preferred
- LCSW/LMFT
- LVN

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

 

Knowledge in: 
- Health Plan or Hospital Federal, State and Accreditation Requirements
- Care Coordination and Transition Management processes
- Principles of performance improvement and program design

Skills Requirement

 

- Good problem-solving, organizational, and leadership skills are highly required.
- Proficient user of basic computer applications for the execution of daily project operations.
- Must possess excellent communication skills so as to be able to effectively convey messages across to both study team members and other external persons like vendors and external consultants.

Abilities Requirement

 

- Ability to organize and motivate other members in the project team.
- Must be able to work as part of a team.
- Attention to detail at all times.
- Must be able to work within a dynamic environment, including managing multiple projects, and pivot or change direction as needed.

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

Work Model Location

Physical Requirements

Keyboarding: Traditional - FREQUENTLY
Keyboarding: 10-Key - FREQUENTLY
Keyboarding: Other - FREQUENTLY
Hearing: One-on-One - FREQUENTLY
Communicate: Information/ideas verbally - FREQUENTLY
Sitting - CONSTANTLY
Indoors - CONSTANTLY
Lighting - FREQUENTLY
Near Visual Acuity - FREQUENTLY
Regular contacts: co-workers, supervisor - FREQUENTLY
Memory - FREQUENTLY
Understand and follow direction - FREQUENTLY
Regular and reliable attendance - CONSTANTLY
Use of computer mouse - FREQUENTLY
Hearing: In a group - FREQUENTLY
Hearing: Over the Telephone/Cell Phone - FREQUENTLY
Hearing: Conference Speakers/Video Calls/Radio Calls - FREQUENTLY
Communicate: Verbally engage with customer base - FREQUENTLY
Walking - FREQUENTLY
Perform complex and varied tasks - FREQUENTLY
Adaptability: rate of change in work tasks - FREQUENTLY
Develop and maintain positive work relationships - FREQUENTLY
Adaptability: rate of change in work location - CONSTANTLY
Regular contacts: recurring clients - FREQUENTLY
Decision-making - FREQUENTLY
Lead/Influence Others - FREQUENTLY
Rapid Pace of work - FREQUENTLY
Problem Solving - FREQUENTLY

 

Starting Salary: $118,248.00  - $150,779.20  

Pay rate will commensurate with experience

 

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. With a provider network of more than 7,000 and a team of more than 2,500 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 a 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