Clinical Systems Strategy Director (Remote - NC)

LOCATION:  Remote – This is a home based, virtual position that operates within the hours of 8:30am-5:00pm EST. The person in this position must live in North Carolina or within 40 miles of the NC border.

GENERAL STATEMENT OF JOB

The Clinical Systems Strategy Director reports to the Vice President of Clinical Strategies.  The individual in this position has a thorough understanding of Vaya’s clinical systems and the overall organizational strategy that informs clinical initiatives and projects. The Clinical Systems Strategy Director has a direct impact on departmental, inter-departmental, and division efficiency and execution, with an emphasis on clinical operations and in the broader context of Medicaid transformation. This position will focus on the alignment of business functions within and between departments. This role informs strategic and operational planning to enable the VP of Clinical Strategies to work most effectively with internal and external stakeholders and fulfill commitments of the department and division. This is a role that requires a combination of focus and flexibility, as well as a willingness to play an active, behind-the-scenes role. As a trusted counsel to the VP of Clinical Strategies, this role requires a highly resourceful individual with strong emotional intelligence, self-motivation, and strong analytical skills. This employee supports functional performance reporting on progress and outcomes and is responsible for fostering transparency and awareness through communication strategies across the department and division. The role serves as a liaison to Clinical Strategies leaders, serves as a business partner for departmental strategy and implementation that relates to and impacts the division, and leads other initiatives as assigned.  The ability to communicate with all levels of Vaya leadership, clinicians, physicians, and ancillary department staff is essential for this position. 

Note: This position requires access to and use of confidential healthcare information or protected health information (PHI) as described in laws addressing patient confidentiality, including, but not limited to, the federal HIPAA law, the Confidentiality of Alcohol and Substance Abuse Patient Records law, 42 CFR Part 2, and various state laws. As such, the individual filling this position shall be required to be trained regarding such laws and shall be required to observe those laws in his/her capacity as an employee of Vaya Health. The individual filling this position shall also sign a confidentiality statement as an employee of Vaya Health.

ESSENTIAL JOB FUNCTIONS

Project management coordination and strategy design:

• Coordinate programs and projects, ensuring resources in the Clinical Strategies Department are prioritized appropriately. Compile project status reports, coordinate project schedules, attend team meetings, and coordinate and assign and follow up on project tasks ensuring deadlines are met.
• Coordinate communication of Clinical Strategies announcements. 
• Coordinate the design, development and publication of Clinical Strategies solutions. 
• Compile, edit, analyze, and disseminate the weekly Clinical Strategies Status Update. 
• Provide coordination for the Clinical Strategies leadership team by responding, tracking, and following up on priorities.
• Understand the breadth of projects within the VP of Clinical Strategies’ s purview.

Financial and contractual program logistics:

• Track, analyze, and maintain Clinical Strategies expenses and ensure expenses reconcile with Clinical Strategies budget.
• Coordinate, track, schedule, and analyze all Clinical Strategies department trainings, ensuring the training expenses are within the Clinical Strategies budget.

Executive coordination:

• Coordinate meetings for the Clinical Strategies VP  
• Ensure meeting objectives are realistic, preparation is appropriate, and that the Clinical Strategies VP is well-prepared.
• Secure alignment among stakeholders, and recommend mitigating approaches when alignment is absent, while managing up to Clinical Strategies VP for visibility. 
• Proactively identify issues that could impact the successful execution of Clinical Strategies commitments, including elevating issues and framing/positioning ideas to resolve the problem/mitigate the risk. 
• Assist in resolving administrative/high-level issues with Clinical Strategies VP and Clinical Strategies leaders.
• Coordinate maintenance and updates of Clinical Strategies Team Standard Operating Procedures manual.

KNOWLEDGE, SKILL & ABILITIES

This position requires a high degree of autonomy, professional relationships and clinical skills. Thorough knowledge of the following:

• DSM 5 and ICD-10 or their derivatives;
• Care coordination, complex care management and population health principles, practices and application;
• Clinical behavioral health (MHSUIDD) and integrated care principles, techniques, and practices, and their application to member care;
• Medical and Behavioral Health provider workflows;
• Medicaid waiver criteria, including but not limited to eligibility for Vaya Health Plan, service definitions, entitlements and restrictions for state plan Medicaid services, 1915(b) and (c) Waivers, 1115 Waiver criteria and general knowledge of Long-Term Services and Supports;   
• Vaya Health contracts with NC Division of Medical Assistance (DMA), NC Division Mental Health/Developmental Disabilities/Substance Abuse Services and other contracts for which Vaya Health is responsible;
• Vaya Health organizational purpose/role per federal and state statute, strategic plan, leadership and departmental roles, relationships and scope;
• Federal and state confidentiality requirements;
• Member and staff health & safety requirements;
• Corporate compliance requirements;
• Vaya Health Policies and Procedures;
• Project management principles.

Additional Requirements include but are not limited to:

• A demonstrated customer service focus with the ability to develop effective working relationships; 
• Current knowledge of clinical practices and related information systems and computer applications; 
• Demonstrated initiative, problem identification, resolution and analytical skills;
• Clear, concise and appropriate verbal, written and electronic communication;
• Ability to present publicly in large group settings; 
• Ability to adapt to rapid changes;
• Effectively implement new initiatives;
• Computer literacy and familiarity with standard office computer software as well as Vaya Health’s Administrative Health Record and/or Care Management Platform, Excel, Visio, Project Management Software or other required portals or data bases. 

QUALIFICATIONS & EDUCATION REQUIREMENTS

Bachelor’s degree in Nursing (RN) or a Master’s degree in psychology, social work, or counseling required.  

• If licensed therapist, a minimum of seven years of social work or counseling experience.
• If licensed RN, a minimum of seven years in an integrated behavioral health team and evidence of coordination across behavioral health continuums. 

Must also have:

• A minimum of three years of Manager level (or equivalent) experience. 
• A minimum of three years of experience in Medicaid Managed Care.  

Required licensure/certification/membership:

PHYSICAL REQUIREMENTS

• Close visual acuity to perform activities that include viewing a computer terminal; and extensive reading. 
• Physical activity in this position includes crouching, reaching, walking, talking, hearing and repetitive motion of hands, wrists and fingers. 
• Sedentary work with lifting requirements up to 10 pounds, sitting for extended periods of time.

RESIDENCY REQUIREMENT:  The person in this role must live in North Carolina or within 40 miles of the NC border.

SALARY: Depending on qualifications & experience of candidate. This position is exempt and is not eligible for overtime compensation. 

DEADLINE FOR APPLICATION: Open Until Filled

APPLY: Vaya Health accepts online applications in our Career Center, please visit https://www.vayahealth.com/about/careers/.

Vaya Health is an equal opportunity employer.