Position Description:

• Reporting to the Principal & Medical Management Service Line Leader, responsible for day-to-day operations of the ECM Program in California, including budget oversight, training and workflow development and recruitment.
• Responsible for operational and financial success of the ECM and CHW, and related operational services.
• Oversight and guidance for direct reports and oversight of all downstream and front-line staff in the department.
• Responsible for maintenance of quality and risk mitigation standards and plan for accounts in coordination with senior account leadership, including assessing the effectiveness of strategies deployed.
• Oversight of all required compliance reporting and auditing activities for areas overseen.
• Directly hire or guide staff to hire, develop and lead a high performing team of clinical and non-clinical professionals that will deliver exceptional support for providers and care for the patient population while meeting quality and financial targets.
• Define goals and objectives guiding the successful delivery of services and return on investment realization for CHS Clients with support from clinical subject matter experts.
• Develop and implement operational population health and practice transformation, including development of process- and outcomes-related key performance indicators (KPIs) for CHS and Clients
• Work collaboratively with Client leadership to develop and execute upon KPIs related to cost, quality, operations, and outcomes of member care.
• Interact regularly with CHS and Client executive teams, department leadership and operational staff throughout CHS and Client organizations to ensure population health and practice transformation operational priorities are aligned with CHS and Clients’ overall direction and goals.
• Provide effective leadership to stimulate a high performing culture.
• As an operational leader, embrace and contribute to our culture of process improvement with a focus on streamlining processes to add value to the organization.
• Manage all assigned aspects of assigned consulting engagements, contracts and projects from scope definition to delivery, assuming ultimate responsibility for the successful completion of contract deliverables, project resourcing and budget management
• Develop and deliver on client deliverables and content to support consulting engagements and assigned projects.
• Operate as a Subject Matter Expert on other engagements based on expertise
• Develop internal strategic initiatives and propose solutions, teams, and resource needs. Lead implementation of proposed recommendations
• Drive sales and business development initiatives, including generating your own new sales leads and driving sales to completion for new clients and existing client expansion, playing a key role in sales pursuit teams, representing the company, and client(s) as appropriate, at various professional networking, public relations and business development events, and developing peer-reviewed articles, sales materials, case studies, internal curricula and trainings
• Achieve assigned revenue target, through a combination of new and expanded business.
• Ensure compliance with all local, state and federal regulations and ethical standards.

Qualifications:

• Registered Nurse, Social Worker, or Licensed Clinician with master’s degree in an applicable field (e.g., MSN, MSW MBA, MPH, MHA) strongly preferred.
• 5 - 10 years of experience in consulting and/or related operations in a health care setting
• Strong communication and interpersonal skills; experience in managing senior key stakeholder relationships.
• Experience and desire to train, motivate, develop, and lead diverse staff.
• High level of proficiency in Excel and other Microsoft Office programs.
• Skills related to effective project management, including strong work ethic, attention to detail, time management, ability to prioritize, problem solving, flexibility and willingness to learn.
• Flexibility to work evenings and weekends as necessary.
• Ability to work effectively on multiple projects with a team in a fast-paced environment.
• Experience with and deep understanding of all aspects of the California CalAIM program including ECM, as well as State of California CHW.
• Prior experience in at least two of the following areas strongly preferred:
  • Network Development
  • Clinical Redesign
  • Behavioral Health
  • Population health management within value-based payment models
  • Quality assurance and performance improvement
  • Regulatory compliance (Medicare, Special Needs Plans, Medicaid, etc.)
  • Health plan accreditation (NCQA, URAC, etc.)
  • Care model redesign for providers and payers.
  • Care Management / Medical Management Care Models
  • SDOH and Community based organization (CBO) integration

Benefits:

As a firm passionate about health care, we’re deeply committed to the health and wellness of our own team members. We offer comprehensive, affordable insurance plans for our team and their families, and a host of other unique benefits, such as a yearly stipend for wellness-related activities, and a paid parental leave program. You can learn more about our benefits offerings here: https://copehealthsolutions.com/careers/why-cope-health-solutions/.What We Do:

COPE Health Solutions is a national tech-enabled services firm, with a population health management analytics software solution Analytics for Risk Contracting (ARC), collaboratively implementing proven products with payer and provider clients to power success in risk arrangements and development of the future workforce. Our multidisciplinary team provides payers and providers with the experience, capabilities and tools needed to plan for, design, implement and support strategy development and execution. We are driven by our passion to help transform health care delivery, align financial incentives to support population health management and build the workforce needed for value-based care.

To Apply:

To apply for this position or for more information about COPE Health Solutions, visit us at https://copehealthsolutions.com/careers/open-positions/.