Vice President, Care Coordination & Care Management

Overview What you can expect!  Find joy in serving others with IEHP! We welcome you to join us in “healing and inspiring the human spirit” and to pivot from a “job” opportunity to an  authentic experience! Reporting to the Chief Medical Officer, the Vice President, Care Coordination & Care Management provides enterprise-level leadership, operational direction, and strategic advancements for core operational care coordination and care management functions. This role is accountable for ensuring IEHP members across all risk levels receive integrated, effective, efficient, and compliant care services that measurably improve health outcomes. The Vice President is responsible for operating across the continuum of care coordination and management, and is accountable for optimizing performance, regulatory compliance (including DSNP requirements), and member experience across all lines of business. This role’s scope includes, but is not limited to, the oversight of key functional areas such as care management, behavioral health, case management, transitions of care and discharge planning, Long-Term Services, and strong coordination with Enhanced Care Management requirements. This role would also be required to coordinate with key county partners as identified. The Vice President will also advance care management and coordination functions through modern, scalable techniques, including the thoughtful adoption and integration of AI tools and innovative care management technologies where applicable. This role will also drive system-wide strategic initiatives in collaboration with key business partners such as Hospital Relations, Network Management, Quality, Medical Management, Population Health & Care Initiatives, and Pharmacy. Commitment to Quality: The IEHP Team is committed to incorporate IEHP’s Quality Program goals including, but not limited to, HEDIS, CAHPS, and NCQA Accreditation. Additional Benefits Perks IEHP is not only committed to healing and inspiring the human spirit of our Members, but we also aim to match our team members with the same energy by providing prime benefits and more. Competitive salary State of the art fitness center on-site Medical Insurance with Dental and Vision Life, short-term, and long-term disability options Career advancement opportunities and professional development Wellness programs that promote a healthy work-life balance Flexible Spending Account – Health Care/Childcare CalPERS retirement 457(b) option with a contribution match Paid life insurance for employees Pet care insurance Key Responsibilities Establish key strategic priorities across core operational care coordination and care management functions. This includes the oversight of key functional areas such as care management and case management, as well as strong coordination with enhanced care management requirements. Ensure member care strategies are harmonized, linked, and streamlined to support key priorities, including value based and quality objectives for all lines of business. This includes accountability for improving quality metrics across key domains within the Care Management and Care Coordination functions. Forecast care coordination, care management, and care outcome trends and needs mapped to regulatory and compliance requirements.  This also includes ensuring meeting the standards of regulatory, compliance, and audit requirements Ensure that all department functions are elastic to meet the demands of a dynamic membership population across all risk types. Executive level accountability to ensure all regulatory and compliance requirements are executed on, across all regulators, including, but not limited to, DHCS, DMHC, CMS and Covered CA. Influence enterprise initiatives and priorities that focus on continuous improvement for member outcomes, including the use of modern tools and techniques such as artificial intelligence where applicable. Partner and built trust with key stakeholders, including, but not limited to, Quality, Medical Management, Population Health, Pharmacy, Hospital and Ancillary Relations, and Provider Network to ensure care is managed and coordinated appropriately across all risk categories. This also includes partnering and building trust with external stakeholders including state, regional, county and local departments, county public health, CBOS, providers, and other county partners as identified.   Serve as a lead in all regulatory audits, including representation in key state, local, and regional committees as applicable. Develop, grow and cultivate high performing teams, while fostering a culture of accountability, collaboration, responsiveness, and performance. Ensure enterprise alignment and integration of care coordination and care management functions across technical departments, such as IT and Informatics, and ensure medical management software is optimized to meet the needs of the team. Identify macro and micro barriers that impact care coordination and care management across-functional departments, including leading internal and external applicable case/care conferences and ensuring appropriate utilization.   Deliver regular team member, senior leadership, executive, and board level reporting, including mitigation of strategic risks. Must ensure that all content is communicated clearly and calibrated to the appropriate audience, including translatable concrete action steps. Create a data informed decision-making process to optimize membership needs. Ensure transparency, consistency, integrity, and accountability within the departments caring for IEHP members. Lead high performing departmental teams with an understanding of LEAN and AGILE methods, as well as relevant AI/Machine Learning use cases. Perform any other duties as required to ensure Health Plan operations and department business needs are successful. Qualifications Education & Requirement Minimum of twelve