VP Clinical practice

Sagility

4d•Remote

About The Position

Sagility is currently hiring a talented Vice President of Clinical Practice. This role is responsible for successfully creating a clinical center of excellence in alignment with the healthcare industry for all delivery parameters and also successfully grow the overall practice revenues. Primary responsibilities include: Support all clinical opportunities for growth seeking technology and/or services. in the Utilization management, care management and clinical front office and back-office scope for healthcare (Payers and Providers) and workers comp products. The support will be in the following areas: Support all Clinical opportunities either via prospecting or from RFPs, from current clients and new prospects Support all sales team with GTM messaging relevant to the product and capabilities and enable/ facilitate growth through appropriate campaigns and marketing events. Prepare and support client meetings, with relevant presentations that communicate Sagility offering relevant for each client, ensuring that the content is customized to the client’s business and priorities Help design solutions for new clinical capabilities in collaboration with the Solutions teams and global clinical teams Work closely with vendors in clinical talent management and helping with a steady sourcing mechanism that is both cost and talent effective. Support all new clinical process transitions with regards to hiring, training, and meeting service levels including but not limited to turn around time, quality and productivity expectations, and contractual requirements. Promote thought leadership with regard to Sagility clinical products and offering to the market within and outside of Sagility. Facilitate learning about market trends, deep clinical care pathways and other relevant topics to clinicians within Sagility to ensure a good learning environment for the clinicians. Manage / Incubate operations for new UM and CM programs with deep understanding of outcome metrics by working closely with clinical analytics, MDs, work force management, business excellence, and training functions in building standard practices across all delivery parameters. This scope will be to deliver successful outcomes to clients, manage client stakeholders during the incubation period and hand off program once stabilized to the operational teams. Be available for periodic, scheduled business reviews with clients for all clinical processes. Represent the practice view points on market trends and innovations and solution sets Proactively engage with business transformation and operations teams to identify innovative solutions that would help improve member and/or provider experience or reduce costs per line of service. Year over year, keep track of shifting market needs, new competitive services and technologies, and key gaps in Sagility capabilities to support the market and to achieve revenue targets from new capabilities. Help elevate the SAGILITY Clinical practice brand in the market, as evidenced by finding and/or guiding prospective Requests for Proposals relevant to newer capabilities that are being developed.

Requirements

Must have a clinical degree (MD/USRN) with at least 5 years’ direct patient care experience within the last 15 years.
Unrestricted license to practice within the United States
8+ years in a corporate role leading clinical practice in the capacity of Clinical sales support, business transformation, clinical product development or Clinical operations
Minimum of 5 years’ experience in a health plan or large health system/ACO preferred.
Minimum of 3 years of management experience, including hiring, training, assigning work and managing performance of leadership teams.
A background that includes strong clinical work, experience in managed care and managing a clinical program in the medical management functions with ability to understand, interpret and apply complex federal and state health care compliance laws, understand financial implications of Utilization and care management functions, rules, regulations, organization and industry-based policies, procedures, and guidelines.
Acute hospital case management, discharge planning, complex case management or utilization management- preferred.
Collaborative and results-oriented approach with all functional teams.
Working knowledge of NCQA, and health plan requirements related to utilization management, population health, and care management.
Excellent computer skills with proficiency in Word, PowerPoint, and Excel.
Experience with utilization management and/or case management software preferred.
Experience in quality, population, and individual data analysis for a variety of services.
Able to resolve conflicts and/or negotiate with others to achieve positive results; establish and maintain effective interpersonal relationships.
Demonstrates resourcefulness, diplomacy, organizational and analytic skills.
Able to work effectively and collaboratively with interdisciplinary teams.
Highly organized, self-directed and able to work independently under general direction and minimal supervision; able to assume responsibility, take initiative, follow up on assignments, make appropriate decisions within the scope of the position, handle multiple projects simultaneously in a high-volume work environment and assume accountability for own decisions and aware of when to escalate issues to management.
Able to delegate work and responsibilities to direct reports and teammates, clearly define objectives and timelines, and maintain oversight of the work and outcomes.
Adaptable to a rapidly changing environment and priorities, keeping supervisor informed of any delays that could disrupt delivery of health care services or internal operations.
Be comfortable with ambiguity while developing strategies for defining standards of operations, scope, and solutions.
Able to work effectively and collaboratively with interdisciplinary teams across global delivery centers.
Ability to develop and implement educational materials and presentations for all levels of learners.
Maintains member information in a confidential manner and ensures HIPAA compliance at all times.
Proficient in speaking, reading, and writing English is required.
Ability to effectively communicate clearly in both verbal and written format.
Ability to effectively present information and respond to questions among a variety of audiences, including patients, providers, internal and external managers, health plan representatives, and vendors in the community.

Nice To Haves

MBA.
Minimum of 5 years’ experience in a health plan or large health system/ACO preferred.
Acute hospital case management, discharge planning, complex case management or utilization management- preferred.
Experience with utilization management and/or case management software preferred.

Responsibilities

Support all clinical opportunities for growth seeking technology and/or services in the Utilization management, care management and clinical front office and back-office scope for healthcare (Payers and Providers) and workers comp products.
Support all Clinical opportunities either via prospecting or from RFPs, from current clients and new prospects
Support all sales team with GTM messaging relevant to the product and capabilities and enable/ facilitate growth through appropriate campaigns and marketing events.
Prepare and support client meetings, with relevant presentations that communicate Sagility offering relevant for each client, ensuring that the content is customized to the client’s business and priorities
Help design solutions for new clinical capabilities in collaboration with the Solutions teams and global clinical teams
Work closely with vendors in clinical talent management and helping with a steady sourcing mechanism that is both cost and talent effective.
Support all new clinical process transitions with regards to hiring, training, and meeting service levels including but not limited to turn around time, quality and productivity expectations, and contractual requirements.
Promote thought leadership with regard to Sagility clinical products and offering to the market within and outside of Sagility.
Facilitate learning about market trends, deep clinical care pathways and other relevant topics to clinicians within Sagility to ensure a good learning environment for the clinicians.
Manage / Incubate operations for new UM and CM programs with deep understanding of outcome metrics by working closely with clinical analytics, MDs, work force management, business excellence, and training functions in building standard practices across all delivery parameters.
Be available for periodic, scheduled business reviews with clients for all clinical processes.
Represent the practice view points on market trends and innovations and solution sets
Proactively engage with business transformation and operations teams to identify innovative solutions that would help improve member and/or provider experience or reduce costs per line of service.
Year over year, keep track of shifting market needs, new competitive services and technologies, and key gaps in Sagility capabilities to support the market and to achieve revenue targets from new capabilities.
Help elevate the SAGILITY Clinical practice brand in the market, as evidenced by finding and/or guiding prospective Requests for Proposals relevant to newer capabilities that are being developed.