Senior Director, Integrated Transitional Care

Date: Sep 15, 2022

Location: Rancho Cucamonga, CA, US

Company: Inland Empire Health Plans

Job Requisition ID: 8040 

 

Position Summary/Position

 

The Senior Director, Integrated Transitional Care primary responsibility to plan, develop and implement an integrated transitional care department that focuses on a person-centered model of care which takes in to account the Members medical, behavioral, and social needs. The integrated transitional integrated management program will provide services to all Medi-cal transitioning hospitals, institutions, other acute care facilities, and skilled nursing facilities to home or community-based settings.

Major Functions (Duties and Responsibilities)

 

1. Design and implement a Medi-Cal Transition of Care program that meets the DHCS requirements.
2. Ensure that the TOC program also meets NCQA requirements.
3. Oversee and ensure all reporting requirements are met as dictated by DHCS.
4. Identify opportunities to provide specialized/targeted interventions for Members identified as having disparities.
5. Collaborate with network facilities to ensure compliance with the transitional care requirements.
6. Perform an annual effectiveness study to identify opportunities to improve the TOC program.
7. Work with the Hospital Relations team on developing hospital/facility communications and tools.
8. Collaborate with other departments in developing a training & pre-delegation audit tool/kit for hospitals or other entities that may be identified as a possible TOC delegate.
9. Collaborate with the Senior Director of Integrated care to align the DSNP and Medi-Cal TOC activities. 
10. Identify opportunities to improve preventative and chronic care metrics for all members engaged in the transitional care program.
11. Train, supervise and evaluate the Director reporting to the Senior Director on an ongoing basis and provide support/feedback as needed.
12. Supervise work of others, including planning, assigning, scheduling, and reviewing work, ensuring quality standards.  Is responsible for hiring, terminating, training, and developing, reviewing performance, and administering corrective action for staff.  Plans organizational structure and job content.

Major Functions (Duties and Responsibilities) Cont

Supervisory Responsibilities

Leader: Administers Hires, Terminations, and Performance Reviews

Experience Qualifications

 

Minimum of ten (10) years progressively responsible experience in managed care setting that serves the Medicaid population or similar populations. Seven (7) or more years of progressive healthcare leadership. Strong clinical experience in multidisciplinary team collaboration, utilization management and transition of care processes.

Preferred Experience

Education Qualifications

 

Bachelor’s degree from an accredited institution required.

Preferred Education

 

Master’s degree from an accredited institution preferred.

Professional Certification

Professional Licenses

Drivers License Required

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

Knowledge Requirement

 

Working knowledge of HEDIS and CAHPs, CMS, DMHC and NCQA regulations health plan regulations.

Skills Requirement

 

Excellent oral and written communication skills. Excellent interpersonal skills, diplomacy, coaching and change management skills. Good Microsoft applications skills (Word, Excel and PowerPoint). Demonstrated problem solving and decision-making skills with ability to exercise initiative. Demonstrated ability to lead teams and achieve successful outcomes and results while fostering a climate of engagement and employee satisfaction.

Abilities Requirement

 

Ability to work independently. Ability to present to large audiences. Ability to work with multicultural communities in a culturally competent manner. Transparent leadership style. Strong work ethic. Commitment to working with vulnerable populations. Able to handle multiple priorities. Commitment to Team Culture. Highly organized.

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

Hybrid

Physical Requirements

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

 

Starting Salary: $219,086.40  - $290,284.80  

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