Director of Health Equity & Member Services

Cascade Comprehensive Care•Klamath Falls, OR

About The Position

This position is responsible for leading, implementing, and evaluating the strategic plans, policies, and procedures to ensure department programs are consistent with the organization's strategy. This position is responsible for monitoring and oversight of the Health Equity Plan and assuring inclusion and completion of all department related deliverables required by contract with the Oregon Health Authority (OHA). This position works with leadership in collaboration with the Delivery System, Provider Network, Medical Management, Community Advisory Council (CAC), and other community stakeholders to support development, spread, and sustainability of Health Equity Programs to reduce health disparities for members by performing the following duties: Leads the monitoring and oversight of member engagement and experience across demographics, identifying disparities in access, utilization, Social Determinants of Health (SDoH) needs, satisfaction, and overall health outcomes for members. Identifies and implements key member touchpoints across omnichannel engagement models to support enrollment, education, and benefits, ensuring timely and relevant interactions and engagement. Leads collaborative member services and health equity improvement work with internal and external partners through engagement, leveraging data and utilizing reliable improvement methods. Promotes community networking and engagement with key stakeholders, providers, state agencies, and member advocates to address health equity and Social Determinants of Health. Leads the development, documentation, and ongoing management of the Member Services and Health Equity department related programs. Monitors and provides oversight of the organization's strategy and best practices in Health Equity (HE) and SDoH models. Cooperates and supports the Quality Department by assisting with the development and implementation of member outreach plans for targeted performance of the Oregon Health Authority Quality incentive metrics. Oversees state and federal contract requirements of the Member Services and Health Equity department that include, but are not limited to, guidance documentation, reporting, templates, audits and timely deliverable submissions. Provides strategy and oversight to monitor and support the Health Equity team with Non-Emergent Medical Transport (NEMT), System of Care (SOC) program, Traditional Healthcare Workers (THW), Improvement plans, Health Equity Plan, and other SDoH-HE related services work. Provides strategy and oversight to monitor and support the Member Services team with appeals and grievances, strategic planning, goal setting, engagement plans, training, and team building. Develops and oversees member and community network listening structures, such as advisory committees, focus groups, networks, and community listening sessions to assist organizational decision making. Provides leadership and support to community and clinical partners engaged in building culturally responsiveness practices in support of the department strategies and Health Equity Plan. Assists senior leadership with the development of programs that work toward alleviating SDoH that directly impact the health outcomes of members and the community such as Flexible Services, SHARE Initiatives, In Lieu of Services, and Health Related Social Needs (HRSN) funding and support. Provides the Member Services and Health Equity Department with appropriate interaction and deescalation technique training. Communicates and collaborates with internal and external entities to accomplish Health Equity Plan improvement goals. Acts as a resource to all staff on SDoH, and Health Equity improvement processes. Maintains the Member Services and Health Equity Department policies, procedures, and practices to ensure compliance with applicable laws and regulations. Tracks and manages complex projects at the department and community level. Maintains confidentiality and complies with HIPAA rules and regulations. Maintains punctual, regular and predictable attendance. Works collaboratively in a team environment with a spirit of cooperation. Displays excellent communication skills including presentation, persuasion, and negotiation skills required in working with members and coworkers, including the ability to communicate effectively and remain calm and courteous under pressure. Respectfully takes direction from manager .

Requirements

Bachelor's degree from four-year college or university
three to five years related experience and/or training
Job requires specialized computer skills. Must be adept at using various applications including database, spreadsheet, report writing, project management, graphics, word processing, presentation creation/editing, communicate by e-mail and use scheduling software.
Strong operational knowledge and experience with Excel and Visio (flow chart equivalent).
Background Check & Drug Screen Required

Responsibilities

Leads the monitoring and oversight of member engagement and experience across demographics, identifying disparities in access, utilization, Social Determinants of Health (SDoH) needs, satisfaction, and overall health outcomes for members.
Identifies and implements key member touchpoints across omnichannel engagement models to support enrollment, education, and benefits, ensuring timely and relevant interactions and engagement.
Leads collaborative member services and health equity improvement work with internal and external partners through engagement, leveraging data and utilizing reliable improvement methods.
Promotes community networking and engagement with key stakeholders, providers, state agencies, and member advocates to address health equity and Social Determinants of Health.
Leads the development, documentation, and ongoing management of the Member Services and Health Equity department related programs.
Monitors and provides oversight of the organization's strategy and best practices in Health Equity (HE) and SDoH models.
Cooperates and supports the Quality Department by assisting with the development and implementation of member outreach plans for targeted performance of the Oregon Health Authority Quality incentive metrics.
Oversees state and federal contract requirements of the Member Services and Health Equity department that include, but are not limited to, guidance documentation, reporting, templates, audits and timely deliverable submissions.
Provides strategy and oversight to monitor and support the Health Equity team with Non-Emergent Medical Transport (NEMT), System of Care (SOC) program, Traditional Healthcare Workers (THW), Improvement plans, Health Equity Plan, and other SDoH-HE related services work.
Provides strategy and oversight to monitor and support the Member Services team with appeals and grievances, strategic planning, goal setting, engagement plans, training, and team building.
Develops and oversees member and community network listening structures, such as advisory committees, focus groups, networks, and community listening sessions to assist organizational decision making.
Provides leadership and support to community and clinical partners engaged in building culturally responsiveness practices in support of the department strategies and Health Equity Plan.
Assists senior leadership with the development of programs that work toward alleviating SDoH that directly impact the health outcomes of members and the community such as Flexible Services, SHARE Initiatives, In Lieu of Services, and Health Related Social Needs (HRSN) funding and support.
Provides the Member Services and Health Equity Department with appropriate interaction and deescalation technique training.
Communicates and collaborates with internal and external entities to accomplish Health Equity Plan improvement goals.
Acts as a resource to all staff on SDoH, and Health Equity improvement processes.
Maintains the Member Services and Health Equity Department policies, procedures, and practices to ensure compliance with applicable laws and regulations.
Tracks and manages complex projects at the department and community level.
Maintains confidentiality and complies with HIPAA rules and regulations.
Maintains punctual, regular and predictable attendance.
Works collaboratively in a team environment with a spirit of cooperation.
Displays excellent communication skills including presentation, persuasion, and negotiation skills required in working with members and coworkers, including the ability to communicate effectively and remain calm and courteous under pressure.
Respectfully takes direction from manager