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Alliance Health Senior Vice President-Population Health-Care Management in Morrisville, North Carolina

The Senior Vice President-Population Health and Care Management shall be responsible for providing oversight and leadership of all prevention/population health and care management programs, including oversight of care management provided by AMH+, State-funded case management providers, and care management agencies and care management delivered by Local Health Departments.Essential Functions and DutiesStrategy Development/InnovationDesign, develop and implement a strategic plan that focuses on clinical excellence and organizational goals.Support continuous quality improvement and measure effectiveness on that plan to demonstrate clinical excellence;iCoordinate and help develop Care Management Department quality improvement initiatives and execute action plans to achieve improvements in targeted domains.Employ a population health approach utilizing data from healthcare systems, governmental agencies, and other sources to improve the health of individuals served by Alliance.Clinical Leadership/Oversight of Population Health, Care Management services and operationsSupervise Alliance Care Management services and operations, including Community Care Management, Transition Care Management, and Integrated Healthcare Management.Oversee state-funded case management providers and care management agencies, including care management delivered by local health departments.Oversee Prevention and Population Health programs.Ensure the delivery of effective, efficient, integrated and evidenced based services and interventions that include physical, behavioral, and social objectives.Ensure the implementation of policies and procedures that maintain member rights.Create and maintain proper operational controls, administrative and reporting procedures and systems to meet and exceed clinical goals of the organization.iEnsure effective operations, support of organized care teams that deliveriinterventions and support under the care management model.ComplianceEnsure that all activities and operations are carried out in compliance with local, state, and federal regulation, Alliance Compliance Plan and all laws governing healthcare operations.Work with Allianceis Legal, Compliance, Organizational Performance and Human Resource Divisions to ensure the department operates in compliance with URAC and NCQA procedures, proactively identifies agency risk, and implements corrective action when needed.Responsible for establishing and implementing a safe working environment that meets all licensure, regulatory, and accreditation requirementsOversee department staffing and trainingWork with Human Resources and departmental directors, managers, and supervisors to maintain a highly qualified and well trained workforce.iiMonitor and manage productivity and clinical integrity including caseloads, completed authorization requests, documentationEnsure staff are well trained in the use of Alliance clinical decision making tools and practice guidelines.Work with the IT department to ensure the department has the needed IT tools to fulfil care coordination functions and support employeesOversee Intradepartmental cooperationEnsure intra-departmental cooperation on cross department initiatives.Internal and External CommunicationProvide timely and accurate reports to Alliance leadership, Board members, providers, the community, staff and stakeholders as needed about service trends, identified gaps and needs, recommended implementation of new processes, practices and effectiveness of clinical model.iiThe SVP of Care Management represents the agency in various state forums, in meetings, with stakeholder, providers and consumersMinimum RequirementsDoctorate in Psychology or related field from an accredited institution with a minimum of five (5) years of demonstrated care management/population health experience in a healthcare organization (health plan experience preferred) serving Medicaid beneficiaries, including experience with BH and I/DD populations experience.OrMasteris d

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