POSITION SUMMARY:

The Director of Enhanced Care Management (DECM) will develop, implement, oversee and manage Valley Community Healthcare’s Enhanced Care Management Program. The DECM is responsible for strategic growth and administration of the ECM program, including developing relationships with healthcare plans, deploying patient outreach, creating clear and direct access and enrollment into the ECM program, conducting ongoing program evaluation, and supervision of ECM staff. In collaboration with the Director of Behavioral Health, the DECM will ensure that high quality care is delivered to patients in an efficient and effective manner.

CORE JOB RESPONSIBILITIES:

Essential Functions:

· Develop, refine and implement program policies and procedures to ensure quality care and compliance with all ECM program requirements.

· Develop Key Performance Indicators (KPI) that align with the company’s goals and ensure that the teams meet the monthly KPIs. Ensure that ECM contract goals and objectives are met.

· Strategically manage the program budget to meet or exceed established goals.

· Inspire team members and expand the program in the assigned region.

· Foster positive employee relations through development of an engaging, diverse, team-oriented culture.

· Provide leadership and guidance to the care management staff, ensuring they are meeting performance standards and goals.

· Oversee the day-to-day activities of the ECM program and provide supervision to the ECM Supervisors, Lead Care Managers, and Community Health Workers.

· Work closely with other departments to provide seamless care to clients.

· Ensure records (electronic and physical) and billing requirements are maintained in accordance with ECM program standards. Collaborate with billing staff to ensure timely claim submission and address denial of payment.

· Oversee assessments, intakes, care planning, crisis management, transition plans.

· Oversee and ensure staff training, both for newly hired and existing staff. Creates onboarding and orientation schedules and meetings for new providers.

· Run Electronic Health Record reports as needed. Participate in VCH managed care committee meetings, develops assessments and action plans of ECM program data, and presents relevant information to committee members. Analyze data and provide reports to senior management on the performance of the programs

· Attend meetings and represents the organization with the IPA, MSO, health plans, and other entities as needed. Provide reports to managed care plans regarding ECM as needed.

· Lead ECM specific meetings and completes administrative tasks as assigned.

· Other related duties as assigned.

Compliance: Ensure services provided comply with regulatory agency requirements, contractual obligations, and funding sources.

· Perform/supervise functions, duties and services in compliance with regulatory agencies, contractual obligations and funding sources such as CHDP, Medi-Cal, HCLA, MHLA, and Medicare. Leads preparation activities and execution of all ECM program audits.

· Leads the review, revision, and implementation of policies and procedures to ensure practices are in full compliance with regulatory requirements.

· Oversees the maintenance of records/documents in accordance with clinic policies and procedures, contractual obligations, regulations, and funding sources.

Communication:

· Creates and maintains effective interpersonal relationships with all employees; keeps employees informed of changes which may affect the work environment.

· Communicates effectively with all levels of staff throughout the clinic by consistently utilizing and facilitating effective strategies to encourage collaborative problem solving and decision making.

· Trouble shoot difficult problems or situations and take action to resolve them.

· Through teamwork and accountability exhibit behaviors and attitudes of courtesy and respect for all staff at the clinic in accordance with its mission and values.

· Ensure patient confidentiality and demonstrates complete discretion when discussing patient information.

Fiscal Management:

· Complete documentation for clinic sessions in a timely manner ensuring accuracy and completeness to ensure the clinic can collect funds for the services.

POSITION REQUIREMENTS:

Minimum Qualifications:

These are general guidelines based on the minimum experience normally considered essential to the satisfactory performance of this job. Individual abilities may result in some deviation from these guidelines. To perform effectively in this position, the candidate must have:

· Masters level (MPH, MPA, LCSW, LMFT) with (5) years of management experience preferable in a heath care setting. Experience in Federally Qualified Health Centers, and/or an NCQA recognized Patient Centered Medical Home is preferred.

· Ability to work with complex and multi-faceted tasks and systems.

· Ability to prioritize tasks and delegate them when appropriate.

· Ability to act with integrity, professionalism, and confidentiality.

· Strong analytical and problem-solving skills.

· Knowledge and experience with Microsoft Office and common personal computer functions such as email, printing/scanning documents, web browser.

· Experience working with culturally, ethically, sexually, and socio-economically diverse populations.

· Ability to work with multidisciplinary team.

· Must be reasonable, flexible, strong oral and written skills; computer literacy.

· Knowledge of federal, state, and local regulatory requirements as they relate to case management & social services and operate within these guidelines.

· Proven success managing budget including labor, expenses & capital expenditures.

· Flexibility to work weekends & evenings as the business requires.

· Valid California Driver's License or Identification.

· Ability to relate and communicate well to all cultural and ethnic groups in the community, including fluency in written and spoken English. Bilingual skills in written and spoken Spanish are preferred.

Job Type: Full-time

Pay: $110,000.00 per year

Benefits:

• 401(k)
• 401(k) matching
• Dental insurance
• Employee assistance program
• Flexible spending account
• Health insurance
• Life insurance
• Paid time off
• Retirement plan
• Vision insurance

Schedule:

• 8 hour shift
• Monday to Friday

Experience:

• Management: 2 years (Preferred)
• FQHC: 2 years (Preferred)
• NCQA standards: 2 years (Preferred)

Language:

• Spanish (Preferred)

License/Certification:

• Driver's License (Preferred)

Work Location: In person