Description
Position at Healthmap Solutions
Company Background
Healthmap Solutions is the future of specialty health management that focuses on progressive diseases, with a particular expertise in kidney health populations. Healthmap Solutions uses clinical big data resources and high-powered analytics to power complex specialty health management programs. Healthmap Solutions is a diverse, growing company committed to our clients and our employees. We are champions for better health, for those who need us most.
Position Summary:
The Care Transformation Lead designs and implements strategies to mentor, train, and develop clinical subject matter experts (Nurses, Social Workers, Dietitians, and non-clinical support staff) in outpatient complex case management and provider engagement focusing on chronic conditions and related programs, including but not limited to CKD, ESKD, Cardiac and Transitions of Care (TOC). Contributes to the achievement of lowering total cost of care for our health plan clients and leverages deep understanding of population health, complex case management, and adult learning principles to drive strategy and appropriate action. Analyzes and monitors performance and outcomes measures to identify clinical, educational, and product opportunities and creates tailored strategies to improve future performance and enhance programs.
The Care Transformation Lead is responsible to establish and implement a comprehensive strategy to empower our clinical workforce to increase member and provider engagement through the value of meaningful interactions, clinical decision making, and effective documentation that will directly lead to the reduction of cost and utilization at the enterprise, client, and program levels, always working to improve clinical care management competence and delivery. This role will require a highly matrixed relationship across the interdisciplinary care delivery teams and serve as a trusted advisor to guide best practice.
Responsibilities:
- Design comprehensive case management competency assessment and corresponding training strategy to improve clinical outcomes across all disciplines and roles.
- Create tailored strategies to improve clinical performance inclusive of the KHM program and identify resources to support staff in the communication and care of members across all programs.
- Partner with Healthmap Quality team to identify and address actionable insights for performance and/or product improvement.
- Identify the need for, design, and perform trainings in collaboration with Enterprise Learning Management (ELM) and Clinical Operations including new hire clinical orientation and onboarding as appropriate.
- Establish and implement coordinated interventions to infuse and promote clinical staff knowledge and long-term competency in all aspects of the KHM program and related initiatives focused on both member and provider engagement as appropriate.
- Maintain current knowledge of evidence-based guidelines for a kidney disease population (e.g., medications, labs, referrals), cardiac population, transitions of care and general complex case management
- Act as consultant, mentor, and trusted advisor to provide direction and collaborate with staff
- Promote opportunities for professional development including but not limited to CMSA Case Management Certification.
- Perform other duties as assigned such as supporting additional programs and initiatives
Requirements:
- Bachelor’s degree in nursing required with an unrestricted RN license
- Master’s degree in nursing, healthcare administration, education or related field preferred
- CCM Certification preferred
- 5 years of complex case management experience in value-based care setting required
- Expertise in clinical consulting, leadership, and/or training in complex case management principles and practice and use of own discretion to deliver compliant, effective strategies to meet established goals
- Ability to design and deliver clinical content to large audiences in an effective and organized manner as well as establish relationships to develop staff 1:1
- Working knowledge of NCQA Accreditation standards for Population Health Program (PHP), Population Health Management (PHM) and/or Standards for Case Management (CCM)
Skills:
- Ability to effectively communicate analysis, implementation strategies, and outcomes to multiple audiences varying from frontline clinical staff to executives
- Strong computer and analytical skills (i.e., MS Word, Excel, PowerPoint)
- Ability to design and implement clinical needs assessments, design and deliver targeted clinical trainings and competency programs as well as identify and articulate KPIs and program success measures.
- Must be a strong public speaker with excellent written and verbal communication skills and experience effectively delivering subject matter expertise to a large audience
- Ability to serve as mentor, clinical resource, trainer and clinical leader for case management programs and clinical excellence standards
- Ability to manage concurrent projects by understanding and reporting on key program performance metrics and ability to prioritize value levers based on expected clinical/financial impact
- Ability to work with multidisciplinary teams and provide support to other Operational Leaders on initiative value, delivery and implementations.
Travel:
Limited Travel, Scheduled per needs of the business
#LI-Remote
Americans with Disability Specifications
The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
As an Equal Opportunity Employer, we will not discriminate against any job candidate or employee due to age, race, religion, ethnicity, national origin, gender, gender identity/expression, sexual orientation, disability, familial status, veteran status, marital status, parental status, or pregnancy. In our innovative and inclusive workplace, we prohibit discrimination and harassment of any kind.
