Director, Enhanced Care Management

Vynca•San Mateo, CA

2d•$145,000 - $160,000•Remote

About The Position

The Director of Enhanced Care Management directs and oversees Vynca’s Enhanced Care Management (ECM) program, including CalAIM program performance, provider and community engagement, care-management operations, policy development, process improvement, risk management, and growth opportunities. The role leads projects from concept through implementation, resolves complex problems, and supports the VP of Clinical Operations in developing strategies to improve health outcomes and patient care while reducing costs. The director develops, implements, supervises, and manages the ECM program and supervises Clinical Managers, Clinical Consultants, Lead Care Managers, and support staff. Responsibilities include administering the program; building relationships with health plans; overseeing outreach, access, evaluation, staffing, training, and care delivery; meeting contract, regulatory, data, and service-level requirements; overseeing records, billing, claims, and reporting; and managing team performance, quality assurance, workflows, KPIs, and financial results. The position collaborates across departments and represents Vynca with external organizations and stakeholders. Applicants are being considered only from Arizona, California, Colorado, Illinois, Nevada, Oregon, Texas, Utah, and Washington. The role supports Pacific Time core business hours, Monday through Friday, 8:30 a.m.–5:00 p.m., and requires travel at least quarterly for leadership and team meetings, including staff training. Work with patients and clients may be remote and/or in person.

Requirements

Bachelor’s degree or equivalent combination of education and experience.
At least 5 years of people-management experience in a similar environment.
Remote workforce and/or multi-site supervisory experience.
At least 3 years of care-management experience.
Proven, results-driven business leadership experience with P&L responsibility.
Superior organizational skills and ability to lead internal and external meetings toward outcomes.
Self-directed, entrepreneurial leadership and flexibility to thrive in a fast-paced, high-growth, dynamic environment.
Proficiency with Microsoft and Google applications and general computer literacy.
Ability to collaborate cross-functionally in a remote environment.
Access to a reliable internet connection.
Ability to work with complex, multifaceted tasks and systems.
Experience working with culturally, ethnically, sexually, and socio-economically diverse populations, maintaining sensitivity in all interactions.
Experience working with multidisciplinary teams.
Willingness and ability to travel at least quarterly for leadership and team meetings, including staff training.
Willingness and ability to support Pacific Time core business hours, Monday through Friday, 8:30 a.m.–5:00 p.m.

Nice To Haves

Master’s degree in Social Work, Public Health, or Healthcare Administration.
Strong understanding of managed care programs, such as Medicare and Medi-Cal.
Experience with Enhanced Care Management programs.

Responsibilities

Refine and implement program policies and procedures.
Supervise Clinical Managers, Lead Care Managers, and support staff.
Oversee day-to-day ECM program operations.
Ensure ECM contract goals and objectives are met.
Ensure contract regulatory and data requirements are met.
Ensure electronic and physical records and billing meet required standards.
Oversee assessments, intakes, care planning, crisis management, and transition plans.
Oversee staffing and staff training.
Run EHR reports as needed.
Oversee claims submission, denials, and receipt of payments.
Represent the organization at meetings with the public, local businesses, employers, health plans, vendors, regulatory bodies, and other external organizations.
Provide ECM reports to management and managed care plans as needed.
Ensure CalAIM program performance and successful execution of all SLAs.
Run an efficient team by defining roles and supporting attainment of goals.
Design and implement department standard operating procedures and workflows.
Develop strategic messaging that communicates the company’s value proposition and addresses patient objections.
Manage quality assurance programs to enhance the client experience.
Develop KPIs that align team-member performance with business objectives.
Manage P&L and report accurate business results in monthly operations reviews.
Apply creative and analytical solutions to business problems and adapt or pivot when needed.
Collaborate with department leaders to foster cross-functional cooperation, especially with business development on referral management and clinical operations on patient onboarding.
Model company core values and ensure staff understand the organization’s values and mission.
Perform other related duties as assigned.