Director of Clinical Integration
Are you excited to step into a complex world that requires a blend of mind, heart and flexibility? We at CareOregon have been strengthening communities since 1994 by making health care work for everyone. As a nonprofit health plan largely focused on Oregon’s Medicaid population, we find fulfillment in supporting the underserved.
And we’re committed to that work in various areas of our wondrous state—including Jackson County, in Southern Oregon. The region is anchored by the small city of Medford, home to our office and in easy reach of rushing rivers, the Pacific coast, Shakespearean plays, wine country, and the majesty of the Rogue River-Siskiyou National Forest. Please consider joining us here at Jackson Care Connect, our Coordinated Care Organization dedicated to our members’ physical, emotional and oral health. We look forward to your application!
General Statement of Duties
The Director of Clinical Integration is responsible for directing the integration and execution of network and clinical strategy for a Coordinated Care Organization (CCO). Time is focused on regional oversight, with secondary time on enterprise-wide engagement. Primary duties include operational planning and oversight, as well as resource, relationship, and people management. This position provides input into strategic plans for the broader organization.
This position operates as a dyad with the CCO Medical Director, assuring financial sustainability and integration of CCO-funded programs, including Quality Pool grants, community risk share funds, APMs and/or other CCO-derived investments for clinical performance. The position is a part of the leadership matrix within the CCO and CareOregon to meet CCO strategic initiatives and mission.
Essential Position Functions
- Partners with CareOregon departments and CCO leadership teams to develop, implement, direct, and oversee programs and policies that provide clinical and operational integration to accomplish CCO strategic goals.
- Leads work of staff and partners to design and implement clinical initiatives that further quality, access, equity and/or cost and utilization goals.
- Reports to CCO Board of Directors on collaborative initiatives and works with the CCO Executive to support the governance structure to be highly effective in meeting goals.
- Supports creation of structures to ensure effective and balanced matrix, as well as reporting, transparency, financial viability and accountability for clinical initiatives.
- Partners with CCO Medical Director to lead the Clinical Advisory Panel and other Board Committees as appropriate to ensure effective clinical input and oversee the operational implementation of all relevant projects and program initiatives.
- Ensures delivery of quality performance targets for the CCO, effective input and appropriate escalation and resolution of issues.
- Directs clinical transformation initiatives and staff in support of CCO strategic priorities.
- Leads the execution of strategic initiatives, plans, and goals in alignment with organizational vision and goals.
- Develops and leads internal systems and measures to ensure effective, efficient, and compliant operations.
- Develops and regularly monitors and reports on performance against metrics.
- Leads innovation, process review, and improvement efforts.
- May serve as a chair for key projects and initiatives.
- Participates in the development of vision, goals, and strategic plans.
- Develops short and long-term plans and policies; oversees the development and execution of standard operating procedures.
- Develops initiatives and programs, including cost savings and revenue optimization programs to support achievement of CCO strategic initiatives
- Provides input into the strategic plans of the organization
- Maintains a business unit view while establishing department priorities, being cognizant of broader business unit and organizational impacts.
- Recommends and manages budgets in alignment with short and long-term CCO plans.
- Manages resources to ensure priorities are accomplished.
- Approves resource allocations within budget, including people, finances, and timelines; makes decisions on exceptions.
- Leads effective communications and matrices with CO department leaders, with emphasis on Population Health, Behavioral Health, Dental, Network and Clinical Supports, and NEMT, ensuring a collaborative culture.
- Builds and ensures effective relationships across internal teams and external organizations for current or future integration of workplans, resources and outcomes.
- Partners with internal leaders and managers in identifying improvement plans and processes.
- Represents the CCO in external meetings and functions, providing productive leadership presence and effectiveness.
Management and Leadership
- Directs team(s), including matrixed managers from relevant CO departments, and establishes team and management goals.
- Provides team members with ongoing understanding of business unit plans and expectations.
- Performs employment functions in collaboration with Human Resources, including staffing, recruitment, performance management, professional development, and termination.
- Coaches, motivates, and recognizes staff.
- Creates opportunities for professional development.
- Leads the development of performance goals, measurement, and evaluation of results.
- Ensures participation in required training initiatives and organizational activities, as well as adherence to external regulations and internal policies.
- Drives a culture of success in alignment with the organizational mission, vision, and values.
Knowledge, Skills and Abilities Required
- Strong understanding of how the functions of a business work and relate to one another
- Knowledge of managed health care, applicable laws, and relationship value with provider networks
- Advanced knowledge of clinical workflows and electronic health record systems within primary care
- Understanding of financial structures, fiscal responsibility, and the economic impact of business decisions
- Ability to design and lead regional clinical integration strategy
- Ability to balance strategic and operational thinking
- Ability to plan, organize, manage, and monitor work projects
- Skilled in budget management and oversight
- Ability to effectively convey business unit goals and plans ensuring integration into strategic plans and initiatives
- Demonstrated leadership effectiveness, analytical capability and ability to design and implement constructive change
- Ability to develop and lead staff, including hiring, goal setting, coaching, performance management, and development
- Ability to communicate effectively, both verbally and in writing, including strong presentation skills
- Excellent collaboration skills for work with network providers and internal employees
- Ability to build and maintain professional relationships with business, community and internal management groups
- Ability to be highly collaborative, cross-functional and systematic
- Skilled in how to confidently diffuse difficult situations and resolve high exposure complaints
- Ability to work with a high degree of diplomacy, credibility and persuasiveness to consistently cultivate effective working relationships; ability to express ideas and gain acceptance
- Ability to work in an environment with diverse individuals and groups
- Motivated to work in a setting with a social mission
- Persistent, assertive, data driven and focused
- Ability to be proactive and action oriented; ability to drive performance and is persistent in accomplishing difficult tasks
- Basic computer skills, including spreadsheet and word processing
Education and/or Experience
- Minimum 8 years’ operational and/or clinical work experience, including 3 years in managed care or innovative care models/quality improvement and 3 years managing people
- 10 years’ relevant experience
- Bachelor’s or Master’s degree in Public Health, Health Care Administration or a related field
- Leadership experience in change management of a clinical delivery system or managed care organization
- Experience in Medicaid, quality assurance, utilization review, and/or case management