Director, Clinical Operations - Carolinas

Description

Who we are:

We believe that Wellvana is the catalyst for systemic change that reimagines and simplifies healthcare, making it easier to practice, access, and navigate for both the patient and physician.

We do this by partnering with practices to reduce administrative complexities and costs while offering individualized data-driven patient care focused on patient health rather than reacting to illness. The result is a system that empowers physicians to do what they love, helping patients, and in turn helps people lead healthier and happier lives. 

Wellvana is one of the fastest growing healthcare companies in 2022. We are founded by Martin Ventures and led by market disrupting leaders who have created and led innovative companies such as Vanguard Health, SmileDirectClub, OrNda HealthCorp, Health Trust, HCA - And we’re doing it again. But this time, you can be a part of it.

The Role:

The Director, Clinic Operations will be working to build and operate a sustainable network of primary care providers, specialists, and ancillary providers. This role will be responsible for developing and maintaining relationships with providers and practices participating in one or more of Wellvana’s value-based care agreements.

What you'll do:

• Serve as team leader for developing and utilizing workflows tailored to the physician’s and practice’s needs. Collaborate with Wellvana’s Directors of Care Management, Coding, and Quality to utilize their resources to achieve KPIs at the practice and market level.
• Provide education and guidance regarding the clinical programs of Value Based Care initiatives related to, DCE, Medicare Advantage, ACO and other at-risk populations, utilizing advanced analytics and reporting to identify patients with high risk and rising risk conditions.
• Lead relationship management with internal and external physicians, their staff, healthcare administrators and healthcare delivery system leaders.
• Review coding, claims, utilization, clinical and quality data. Effectively communicate, build and execute improvement plans at both the market and practice level, based on areas of opportunity identified.
• Facilitate patient follow-up after unplanned admissions and ED visits through coaching of providers and their staff. Collaborate with providers and their staff to improve continuity of care and streamline the intervention process.
• Assess quality and patient’s access to care at the practice level, developing relationships with service providers, and tracking interventions and outcomes.
• Aid in business development by collaborating with the Market President to identify and engage with potential network primary care providers who would benefit from participating in Wellvana’s value-based care agreements.
• Perform other job duties as assigned.

Requirements

Who you are:

• Experience with Managed Service Organizations highly preferred (ACO, DCE, Medicare Advantage, Medicare Shared Savings Program, etc).
• Bachelor's degree in healthcare related field and/or clinical certification required.
• At least 3-5 years of experience in a payor system, hospital, or Primary Care Physician office setting. Prefer experience in quality/HEDIS measures, case management, care coordination, nursing, medical coding/auditing or healthcare administration.
• At least 3-5 years of collaborating and working with physicians (preferably in Primary Care), overseeing and directing healthcare programs, as well as earning patient, provider, and customer trust.
• Proven history of excellent project management and organizational skills, with evidence of progressive leadership and management responsibilities.
• Technologically savvy, with the ability to learn department and job-specific software systems (MS Office, Smartsheet)
• Demonstrate effective verbal and written communication skills, with attention to detail and a high degree of accuracy.