Senior Director, Healthcare Informatics

Date: Jan 8, 2022

Location: Rancho Cucamonga, CA, US

Company: Inland Empire Health Plans

Job Requisition ID: 6619 


Position Summary/Position


At Inland Empire Health Plan (IEHP), we believe the highest quality of care should be delivered to all in the Inland Empire.  We are thinking beyond the way Quality is viewed today – we believe it should be holistic and transformative.

Reporting to the Vice President of Quality, the Senior Director of Healthcare Informatics is responsible for:
- Leading and advancing our current approach to Quality by leveraging people, process, data, and technology with a goal towards improved health plan ratings 
- Leading Informatics teams that support various business units across the organization including Quality, Health Services, Provider Services and Operations
- Partnering with other Informatics leaders across the organization to establish and adopt best practices in informatics and analytics
- Identifying data needs, requirements and applications in the ambulatory and acute hospital setting
- Optimizing the use of clinical systems through education, training, and support in service to improving quality outcomes
- Participating cross-functionally in business planning efforts to support IEHP’s Mission, Vision and Values; and
- Navigating quality regulatory requirements in the Medi-Cal space.

Major Functions (Duties and Responsibilities)


1. Provide Direction to and oversight of the Informatics teams within the Quality System’s department, with a director and two managers as direct reports, a team of 38 staff, and 10 additional open positions.  These teams are responsible for providing informatics support to the following functional business areas: Care Management, Behavioral Health, Population Health, Utilization Management, Grievance and Appeals, Health Education, Network Development, Provider Services, Credentialing, Program Evaluation.  
2. Act as a liaison between clinical areas and IT and Informatics teams to ensure data decision support needs are met.
3. Serve as clinical contributor to the organization’s Informatics teams, providing coding, methodology and tools guidance, as needed.
4. Guide the Program Evaluation and Program Analytics Teams to develop and present formative and summative evaluations to internal/external customers and collaborates with project team members to monitor progress and develop strategies to address barriers.
5. Lead IEHP’s analytic strategy around risk stratification, GIS analysis, population health trends and analysis, program effectiveness and ROI analyses.
6. Collaborate with interdisciplinary business units in support of clinical quality improvement outcomes. 
7. Assist in the development of the organization’s policies and procedures on the use of clinical information systems.
8. Report on existing data and technology trends, regulatory standards (CMS/ONC), and market influences. 
9. Identify, implement, and enable clinical workflows at the practice level to improve data capture and reporting.  
10. Serve as a liaison with external vendor partners to successfully align and scope data work that align IEHP’s strategic plan. 
11. Discover and define the need for new clinical systems, including EMR and registries, to achieve a health plan 5-star rating. 
12. Develop specifications to support successful implementation of clinical data applications across the enterprise. 
13. Guide and direct Informatics teams to deliver dynamic data reports that clearly communicate results and progress. 
14. Communicate difficult concepts in a concise, elegant, and effective ways to key stakeholders, including providers, to reach consensus.
15. Develop clinical rules and models to support high quality care delivery and protocols.

Supervisory Responsibilities

Leader: Administers Hires, Terminations, and Performance Reviews

Experience Qualifications


Ten (10) years of progressive experience working in the healthcare analytics field, leading high functioning teams in the healthcare analytics field. 
Including experience in:
- Care coordination and care/disease management in an ACO or FQHC environment.
-  Working in and with various EMRs and EMR data sets.

Education Qualifications


Doctorate in a related field (PhD) from an accredited institution required.
Medical Degree in a clinically related field (e.g., MD, DO) from an accredited institution required.

Professional Certification


Board Certification in Clinical Informatics Preferred 

Professional Licenses


Preferred possession of an active, unrestricted, and unencumbered Physician’s and Surgeon’s Certificate issued by the State of California Medical Board required (MD or DO).

(A physician certified in a state other than California may be employed prior to receipt of California certification provided that an application for a California physician and surgeon’s certificate is filed in the state of California prior to date of appointment.)

Drivers License Required

Yes, must have a valid California Driver's License.

Knowledge Requirement


- Demonstrated knowledge of working with large healthcare data sets to produce insights in support of answering business questions. 
- Working knowledge of standard coding sets as used in analytics and data mining including ICD-10, CPT, CPT Category II, HCPCS, LOINC, NDC, RX Norm, SNOMED, UB-REV.
- Strong understanding of clinical regulatory environments, including CMS, ONC and NCQA.

Skills Requirement


Proficient in Microsoft Office Suite. Proficient in using analytics tools like:  SSRS, SAS Enterprise Guide, MS Access, Tableau, SPSS, PowerBI, others.

Abilities Requirement


Ability to:
- Lead others in developing new skills, meeting customer demand, fostering team-based culture.
- Interpret complex data and analytics outputs into meaningful and actionable insights that can drive business decisions.
- Communicate effectively both verbally and in writing.
- Communicate difficult concepts in a concise, elegant, and effective way to key stakeholders, including providers, to reach consensus.
- Establish and maintain effective and cooperative working relationships with IEHP staff and other contacts.
- Assume responsibility and exercise good judgment in making decisions within the scope of authority of the position.
- Think and work effectively under pressure and accurately complete tasks within established time parameters.
- Prioritize tasks and meet deadlines; and maintain confidentiality.

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.

Physical Requirements

Keyboarding: Traditional - FREQUENTLY
Keyboarding: Touch-Screen - FREQUENTLY
Keyboarding: 10-Key - FREQUENTLY
Hearing: One-on-One - FREQUENTLY
Communicate: Information/ideas verbally - FREQUENTLY
Near Visual Acuity - FREQUENTLY
Regular contacts: co-workers, supervisor - FREQUENTLY
Understand and follow direction - FREQUENTLY
Regular and reliable attendance - CONSTANTLY


Starting Salary: $181,292.80  - $240,219.20  

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 6,000 and a team of more than 2,000 employees, IEHP provides quality, accessible healthcare services to more than 1.2 million members. And our mission and core 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 retirement plan.


Nearest Major Market: Riverside
Nearest Secondary Market: Los Angeles