Director, Clinical Care Partnership
Company: Commonwealth Care Alliance
Posted on: January 16, 2020
The Director, Clinical Care Partnership is responsible for the
leadership, management and oversight of five to seven multi-level
teams comprised of Clinical Managers and their direct reports. The
Director, Clinical Care Partnership provides guidance to the
clinical managers and is accountable for the outcomes of
interdisciplinary Care Teams, which, in their totality, make up the
CCA clinical enterprise spanning across the Commonwealth of
Massachusetts. The Clinical Enterprise is accountable for the care
management, care coordination, and provision of enhanced primary
care to a majority of CCA s SCO and One Care membership. This
position reports into the Vice President of Clinical Services.
* Provide leadership, individually and through multilevel direct
reports to meet the clinical and health plan metrics, initiatives
and activities set by CCA Clinical Leadership all while remaining
aligned with CCA s mission and values. Follow through/follow up,
respond to the data/metrics associated with the work of the teams,
provide guidance and leadership to meet organizational goals.
Responsible for the ongoing operations of the teams.
* Accountable for KPI s associated with the Clinical Enterprise
including lead and lag measures such as admission/readmission
rates, total medical expenditure, MDS timeliness, HCC scoring
accuracy, closing of HEDIS quality gaps, ACA completion, and
activities associated with the timely decisions of prior
authorization service requests.
* Accountable for the KPI s associated with CCA s Care Delivery,
ensuring that the care provided directly by CCA clinicians is of
the highest quality and appropriate for the individual needs of the
member. KPI s include medication adherence, evidence of positive
management of chronic disease, evidence of management of urgent
needs, and Advanced Care Planning.
* Accountable for KPI s associated with member experience:
including timely engagement between newly enrolled members and
their care partners, standardized frequency of visits, appropriate
utilization of CCA s internal clinical services to decrease acute
* Promotes behavioral health integration within the teams by
maintaining close collaboration with BH leadership.
* Engage as needed with cross-functional leaders and external
stakeholders including partnering PCP s, ASAPs, and Independent
Living Centers to enhance communication and relationships across
* Acts as a liaison and maintains good working relationships with
external collateral providers such as ASAP s, HSP s, primary care
sites, state agencies, and hospital systems.
* Makes recommendations to leadership on approaches to enhance the
effectiveness of clinical practice and programs.
* Leads team strategy and planning meetings, conferences, and
organization wide meetings.
* Participates in budget development by forecasting staffing needs,
defining space and operational requirements. Manages the monthly
budgets for the clinical group, including evaluating variances and
creating action plans to prevent further variances.
* Responsible for reviewing and distributing cost and utilization
data across teams, as appropriate. Transitions data and
expectations to direct reports and ensure follow through.
* Investigates, documents and reports on complaints.
* Works with HR and other managers to hire, retain, and recruit for
positions as needed.
* Direct supervision including performance reviews for direct
reports. Manages performance tracking system to ensure performance
reviews are up to date and improvement systems are in place, where
* Be an available resource to support the clinical team/s and
conduct home visits, as needed.
* Identify and foster career development and advancement
opportunities for members within the team.
* Coaches, mentors and trains new and existing team members in
political, organizational, industry/business, behavioral and
* Nurse Practitioner, Advanced Practice Clinician or Masters level
degree highly desired.
* Minimum Master s degree or equivalent experience.
* Licensed to practice in an advanced role with 5-7 years of
progressive relevant clinical based administrative management
experience in a healthcare environment.
* Proven skills, knowledge base, and judgement necessary for
independent clinical decision making in alignment with
* Excellent organizational, time management, and problem
Commonwealth Care Alliance is an equal opportunity employer.
Applicants are considered for positions without regard to veteran
status, uniformed service member status, race, color, religion,
sex, national origin, age, physical or mental disability, genetic
information or any other category protected by applicable federal,
state or local laws.
Keywords: Commonwealth Care Alliance, Springfield , Director, Clinical Care Partnership, Healthcare , Springfield, Massachusetts
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