Director Delivery Systems Operations & Performance Management

Company: Centene
Location: Rancho Cordova
Posted on: June 21, 2022

Job Description:

You could be the one who changes everything for our 25 million members. Centene is transforming the health of our communities, one person at a time. As a diversified, multi-national organization, you'll have access to competitive benefits including a fresh perspective on workplace flexibility.Position Purpose: -Under general direction of the VP Provider Performance and Analytics, the Director Delivery Systems Operations and Performance Management will be responsible for organizing, managing, driving work to conclusion and maintaining performance levels related to health care delivery (including medical management, provider network management and behavioral health services) for Provider systems.
Essential to success in this role is proven ability to execute in highly matrix supported environment. -The Director Delivery Systems Operations and Performance Management must be capable of managing two or more mid-sized, cross-functional projects (15+ participants and/or $500k+ budget). -This Director will lead a team of 10+ associates focused primarily on (1) gaining access to high quality clinical and social health information as available via HIEs, EMRs, CIEs, SHIEs, HMIS, CAIR and other sources, then working with others to (2) maximize value and usability of data obtained, (3) use data to determine steps and actions which are of highest priority for improving quality outcomes and reducing risks, and (4) provide insights to the right people at the right place at the right time so most effective action can take place.Acts as a champion in CA market for appropriate data sharing and interoperability within the health care industryCollaborates with Provider Oversight, Health Services, State Health Programs, Medicare leadership and Network Management to monitor capacity and performance of contracted medical groups and long-term services while supporting healthcare, social services and behavioral health providers to ensure goals are met.Serves as primary business POC on assigned projects; collaborates with CA market departments and corporate teams frequently to align on interoperability roadmap.Responsible for accurate analysis and assessments of care quality and access by members. Supports identification, development and monitoring of business performance improvement plans as necessary.Understand industry leading standards such as FHIR, EHR proprietary APIs, HL7, etc.Facilitates complex problem resolution between providers and vendors within the delivery system and internal operations.Responsible for keeping abreast of business needs and issues related to systems and performance success and satisfaction of members and providers by maintaining ongoing interaction with internal operation units.Serves as project leader for large scale, cross-functional initiatives to drive performance improvement, financial gains, customer satisfaction and improved compliance.Organizes work teams to accomplish project work: including identification and confirmation of participants, establishment of project plan, consistent work team engagement and productivity, meeting facilitation, consensus building, recommendation documentation and implementation oversight.Performs detailed analysis of data, workflows, policies, procedures, organization of staff, and skills in order to execute initiatives. Investigates and validates improvement opportunities.Oversees the support of established internal and external committees by organizing and publishing agendas, documenting minutes, maintaining work plans, performing follow up and preparing and publishing reports.Manages project plan and ensures team members deliver work with agreed-upon schedules.Supports project work by utilizing project management software or other approved tools.Prepares communications and presentations to all levels of the organization as well as external audiences.Assists in building process improvement and project management skills and serves as project leader for large scale, cross-functional initiatives.Provides effective leadership to staff, with particular attention to recruitment, mentoring and ongoing leadership to make a great work environment.Travel abilityOur Comprehensive Benefits Package:Flexible work solutions including remote options, hybrid work schedules and dress flexibilityCompetitive payPaid Time Off including paid holidaysHealth insurance coverage for you and dependents401(k) and stock purchase plansTuition reimbursement and best-in-class training and developmentEducation/Experience:Bachelor's Degree in Business or related field required.5-7 years experience supervising staff and/or coordinating large, multifunctional project teams.Minimum 7 years project management or equivalent experience leading cross-functional initiatives in complex organizations. -3+ years of experience working with Health Information Exchanges (HIEs) or similar organizations focused on leading and implementing data exchange and driving interoperability within the health care industry highly preferred.License/Certification: Project Management Certification preferredCentene is an equal opportunity employer that is committed to diversity, and values the ways in which we are different. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other characteristic protected by applicable law.Job SummaryJob number: 1314780Date posted : 2022-04-05Profession: Business Development & SalesEmployment type: Both

Keywords: Centene, Rancho Cordova , Director Delivery Systems Operations & Performance Management, Executive , Rancho Cordova, California