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Director, Integrated Care and Innovation Operations – Commonwealth Care Alliance

This job listing has already closed.
Location: *Not in North Carolina
Position Type: Full-time
Closing Date: November 13, 2021

Commonwealth Care Alliance (CCA) is on a mission to improve the health and well-being of the members and patients we so proudly serve. We deliver unparalleled, compassionate care to people with significant needs—driving incredible outcomes in the process. Our innovative uncommon care model is proven effective in addressing unmet social determinants of health, behavioral health, and medical needs.

Why This Role is Important to Us
The Integrated Care and Innovation Operations Director is responsible for the building, integration, improvement and expansion of innovative CCA programs in the acute care, engagement, and primary care space. This role may include responsibility for future innovative clinical programs that fall under the scope of the VP, Integrative Program Development and Clinical Innovation.
The Director has a focus on policy analysis, innovation programs operations development and systems design, providing leadership for cross-functional work in the areas of policy/advocacy, social determinants of health, community partnerships and value-based care. The Director reports to the VP, Integrative Program Development and Clinical Innovation, and partners with teams across CCA.

What We’re Looking For
Bachelors’ degree required, Masters’ degree or equivalent experience preferred
10 years +
• 10+ years of experience designing, managing, evaluating and growing programs at health or human services organizations. Experience with integrated care management programs, health insurance, and populations with complex health needs strongly preferred.
• Experience with Medicaid and Medicare policy, including policy and advocacy writing experience, preferred.
• Experience developing and managing value-based purchasing contracts for community partner providers.
• Strong interpersonal and communication skills; demonstrated ability to use verbal and written communication skills and interpersonal skills to influence, negotiate, persuade, and resolve conflicts.
• Ability to work in a fast-paced environment with changing priorities while maintaining-and fostering in staff and partners-a positive and productive attitude, striving for excellence and continuous quality improvement.
• Ability to identify systemic problems and facilitate processes to develop and implement solutions.
• Strong leadership and organizational skills; successful experience managing cross-functional teams and projects.
• Demonstrated ability to readily master new business and health care content and employ the subject matter expertise in managing project content and staff.
• Excellent organizational, time management and problem-solving skills
• Ability to function effectively in a matrixed, cross-functional team-based environment.

English required, bilingual desired

What You’ll Be Doing
• Operations design: partner with clinicians to design and implement value-adding service components to CCA innovations programs, adjusting staffing models, process workflows, and operating procedures to build a more comprehensive and integrated member experience encompassing the continuum of care. Establish and monitor KPIs to assure high quality operations and outcomes, partnering with Business Intelligence to drive the development of performance dashboards for new services.
• Market intelligence: Monitor and maintain current understanding of evolving health care landscape, particularly the acute care, complex care management, integration and patient engagement spaces, conducting research and regularly briefing innovations team and other key CCA leadership on ideas for partnerships and adaptation.
• Contribute to new market clinical strategy development by conducting research on health policy environment in key geographic areas and designing / adapting clinical operational processes and documents to support rollout.
• Partnerships and value-based care: Engage in partnerships with government and community-based entities. Research and assess potential for community partnerships with innovations program and provide subject matter expertise for development of value-based payment models. Monitor external landscape of value-based models for business intelligence; brief key CCA leaders on models of interest. Partner closely with Network, Business Development and other teams to develop and refine partnership models when appropriate.
• Program materials development: Serve as team lead in preparing presentations, memos, white papers and other briefing documents to support internal decision making; craft presentation materials appropriate for external audiences to promote CCA innovations programs.
• Social determinants of health: Research developments in SDOH-health care space to inform CCA innovations programs. Support the design and implementation of new approaches addressing negative health outcomes of social determinants of health, in areas such as housing, into CCA’s innovations area programs.
• Emerging challenges: Contribute to the timely establishment of activities and programs to address emerging challenges such as the covid-19 pandemic and climate change, and the unique barriers to wellness and care that such developments present to CCA members, particularly those with existing vulnerabilities related to social determinants of health (e.g., homelessness) or other issues.
• Member engagement: Partner with Member Voices team to solicit members’ inputs on developing and refining programs, considering innovation programs’ interface with Member Journey Work with innovation program teams (e.g. at CSUs, Engagement Centers) to coordinate evolution of processes and operating documents to incorporate member feedback. Ensure incorporation of member perspective into team’s planning.
• Assess CCA membership needs and trends impacting access, experience, outcomes and cost of care to inform innovation program planning.
• Policy and advocacy: Act as team lead for cross-functional policy and advocacy work related to clinical innovations and integration, coordinating with Government Relations team and varied clinical leadership to assess impacts of policy changes on CCA services, research legal and regulatory frameworks governing newly developing CCA innovation services, and inform approach to refine, integrate and expand programs. Brief team and other key clinical leaders on analyses and propose next steps. Lead writing, and coordinate of team inputs, for advocacy work such as letters and testimony.
• Technology: ensure the optimal use of telehealth and other developing technologies into CCA’s acute care, primary care and innovations programs, working cross-functionally to develop and operationalize process workflows to increase efficient access to care, address disparities and optimize service utilization. Assess new technologies’ appropriateness for piloting and rollout with CCA programs.
• Growth: Support innovations program expansion to new sites, adapting processes and refining approach and operations, and managing relationships with community partners.
• Health equity: Contribute to cross-functional work on health equity — with design and evaluation of existing and new innovations programs that promotes health equity and addresses racial/ethnic health disparities, eliminating and mitigating factors creating barriers to health, and promoting equitable care and outcomes.

CCA is hiring for many clinical and macro positions. Learn more here: