Director of Care Management

Company: NTT Data Inc
Location: Missoula
Posted on: May 16, 2020

Job Description:

Description

NTT Data seeks a full time, direct hire Director of Care Management (with a clinical background) for our customer in Missoula, MT.

** NTT Data is assisting our healthcare client with the recruiting efforts for this position. This is not a position with NTT DATA.**

RESPONSIBILITIES:

The Director Care Management is responsible for the overall strategy, operational performance and outcomes of the department's care management activities.

This position manages the design, development, and refinement of care management and associated functions to create a continuum of integrated care and experience for our members.

The director collaborates across the enterprise and with clients to ensure that objectives are aligned, business strategies are delivered and financial and compliance and quality objectives are met.

Provides leadership and operational oversight of Care Management programs. Provides leadership and direction to the Care Management team and is responsible for oversight and maintaining of URAC accreditation.

The incumbent is expected to conduct all communication and assignments professionally with peers, supervisors, subordinates, vendors, customers, and the public.

ESSENTIAL JOB FUNCTIONS:

Essential job functions include the following. Other functions may be assigned as business conditions change.

Strategic development and implementation of care management programs

Provide strategic direction, leadership, and operations oversight to programs and staff to optimize efficiency and effectiveness of Care Management operations

Responsible for maintaining confidentiality standards, as mandated by URAC and HIPAA.

Collaborate with strategic partners to innovate, design and deliver market differentiating health management strategies that align to corporate initiatives.

Communicates and collaborates with senior medical director and Chief Medical Officer for medical management, clinical programs and clinical issues that arise.

Direct operational readiness and regulatory/accreditation compliance via formal processes such as policy and procedure, program descriptions, auditing, training, and metric monitoring and management.

Lead the evaluation of program performance based on analysis of data and market requirements to identify and act on opportunities to enhance and improve.

Oversees the development and coordination of quarterly productivity reports and client reporting.

Create and foster an environment where Care Management staff can work effectively and efficiently.

Leads and directs a high performing team including interviewing and hiring employees. Conducts performance evaluation and is responsible for managing employees, including skill and career development, policy administration, coaching on performance management and behavior, employee relations and cost control.

Oversees the onboarding process of new Care Management staff and training processes to ensure staff are set up for success.

Develop educational plans and implementation of annual training for skill and career development of staff.

Works collaboratively with the implementation team and workflow process when adding new clients.

Facilitate and monitor client reporting.

Oversee the cost savings analysis for the Case Management and Utilization Management staff for the individual group plans.

Oversee URAC compliance and application/certification processes for the Utilization Management Department.

Participate in administrative meetings with Care Management customers, Account Representatives or other group contacts upon request as assigned by supervisor.

Performs other duties and responsibilities as assigned.

JOB SPECIFICATIONS:

To perform this position successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions

Bachelor's degree in health care administration, healthcare management, Bachelor of Science Nursing and 5 years of progressive experience in the health care industry or 10 years of relevant experience in lieu of degree.

3 years of progressive management experience.

Current licensed clinician

Demonstrated maturity, flexibility and capacity to navigate a complex structure with strong critical thinking, problem solving/conflict resolution skills.

Superior facilitation, written and oral communications skills to convey complex ideas simply, through written reports and presentation materials.

Strong leadership skills with the ability to generate ideas, support and commitment from constituents.

Demonstrated team building, mentoring and coaching skills with experience leading professional staff.

Demonstrated knowledge of healthcare payer industry and business processes.

Ability to see across the enterprise and identify potential risks and issues that influence other ongoing work efforts.

Strong teamwork and interpersonal skills at all levels.

Must be able to work effectively with cross functional groups, fostering teamwork with a commitment to quality.

Strategic thinking and critical decision making at an enterprise level.

The Company is an equal opportunity employer and makes employment decisions on the basis of merit and business needs. The Company will consider all qualified applicants for employment without regard to race, color, religious creed, citizenship, national origin, ancestry, age, sex, sexual orientation, genetic information, physical or mental disability, veteran or marital status, or any other class protected by law. To comply with applicable laws ensuring equal employment opportunities to qualified individuals with a disability, the Company will make reasonable accommodations for the known physical or mental limitations of an otherwise qualified individual with a disability who is an applicant or an employee unless undue hardship to the Company would result.

Keywords: NTT Data Inc, Missoula , Director of Care Management, Executive , Missoula, Montana