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Vice President, Integrated Care Delivery - Comprehensive Kidney Care C

Company: i4 Search Group
Location: San Jose
Posted on: September 14, 2020

Job Description:

Vice President, Integrated Care Delivery - CKCC

We are more than simply a dialysis company. We have become the industry's leader in personalized quality care: 70% of our centers earn 4- and 5-star ratings from Medicaid and [Click Here to Apply] far ahead of all other providers. Our success in caring for patients can be attributed to our mission, our not-for-profit structure, and our people. Together, they create a powerfully patient-centered organization.

Our mission is clear: to make life better for people living with kidney disease. Because we are a non-profit, we can pursue that mission with all our resources, united by our passion for patient care. As part of our commitment to continuous improvement, Our research explores new ways to elevate the effectiveness and delivery of dialysis therapy. And we are leading the industry in home dialysis because better outcomes and quality of life are our highest priority. We are also substantial contributors to community and philanthropic kidney initiatives.

Across our organization, we share a single mission - to make life better for those living with kidney disease.

About the Role

The CMS Comprehensive Kidney Care Contracting (CKCC) program is designed to reduce Medicare expenditures while preserving or enhancing the quality of care furnished to beneficiaries with late-stage chronic kidney disease (CKD) and end-stage renal disease (ESRD). This position is responsible for setting a strategic vision and overseeing the day-to-day operations of a new integrated care delivery model providing comprehensive care management for high needs patients. The CKCC program design will assess the patient's and caregiver's needs, develop tailored care plan for each individual, organize and adjust care processes accordingly, monitor quality of care and maintain contact with the patient and caregiver.
Integrated health services delivery is an approach to strengthen people-centered health systems through the promotion of the delivery of quality services across the patient health journey, designed according to the multidimensional needs of the population and the individual and delivered by a coordinated multidisciplinary team of providers working across settings and levels of care. The delivery model is expected to achieve improved patient satisfaction and activation, improved clinical outcomes and decreased total medical expense through a patient-centered philosophy that focuses on patients' needs.
Components of a successful program include targeted interventions to meet the needs of the most vulnerable and highest cost patients, and developing clinical partnerships and community collaborations that strengthen connections across the continuum of care. The program should be designed to ensure optimal outcomes and the appropriate use of resources based on the best available evidence, with feedback loops to continuously improve performance and to address systemic and individual upstream causes of ill health and to promote well-being.
A successful program will:

  • Enable cooperation between health and social care organizations, and mobilize community resources to meet needs of patients by addressing social determinants of health
  • Create a health system culture, organization and mechanisms that promote safe, high quality care
    • Design a delivery system that ensures the delivery of effective, efficient clinical care and self-management support, with an emphasis on encouraging greater use of home dialysis and kidney transplants for Medicare beneficiaries
    • Empower and prepare patients to manage their health and health care, including strategies to enhance patient engagement and participation, address social determinants of health and chronic conditions, and encourage the self-management of medications to reduce the incidence re-admissions.
    • Promote health equity through provider-developed, evidence-based care guidelines and protocols to enforce one standard of care regardless of where patients are treated
    • Provide care management decision support to promote clinical care that is consistent with scientific evidence and patient preferences
    • Clinical information systems that organize patient and population data to facilitate efficient and effective care, enhance communication and information flow across the continuum of care and collect, track and report activities
    • Provide direction to ensure effective implementation and compliance with CMS program guidelines
    • Identify and address care gaps within the patient population
    • Improve provider satisfaction A successful effort also requires building a comprehensive plan to capture, analyze, and utilize data on inputs and outcomes, including careful tracking of clinical interventions, costs, patient compliance, satisfaction and real-life outcomes. The model will require medical economic analysis to drive the strategy and design and implementation of population care management initiatives around quality improvement, risk score accuracy, KPIs and improvement in ineffective utilization.
      Essential Job Functions
      • Define key program elements for Medicare and Managed Care model programs, including: patient selection criteria, care management workflows and processes, team role composition, staffing ratios, etc.
      • Develop work plans to ensure effective execution of quality, utilization, service delivery and financial processes to meet business goals and standards
      • Manage programs and interventions using evidence-based strategies across the care continuum to improve patient outcomes at the population health level targeted at key program outcomes, including but not limited to patient activation, depression remission, blood pressure control, optimal ESRD starts, hospitalization and per capita costs, reduction in ED and avoidable inpatient visits
      • Define methods for measuring program success and demonstrating program effectiveness in managing total cost of care; partner with clinical analytics leads to define data and reports needed to manage performance
      • Lead/facilitate/attend focus groups and meetings as needed to strategize workflow issues. Engage stakeholders to develop and document standardized key workflows and guidelines. Establish processes and mechanisms that obtain and respond to clinician feedback.
      • Centrally manage and implement a standardized care management program, but also understand the nuances of local clinical site dynamics and partner with local site leaders and existing local site programs to ensure program success
      • Collaborate on the development of service level agreements with key partners and develop processes to ensure successful partnership relationships that establish accountabilities and ensure a patient-centered approach to achieving quality outcomes and financial benchmarks.
      • Routinely report to Executive Leadership regarding metrics, project status, and roadblocks
      • Work directly with the executive team to ensure that the CKCC model infrastructure is financially sustainable.
      • Ensure that all outreach materials, education, care management programs, and customer service standards are patient centered and align with Satellite's mission, vision, and cultural values
      • Ensure care delivery model is appropriate to level of licensure.
      • Drive the operationalization of necessary population health analytics, reports and EMR needs necessary to execute the strategy. Identify opportunities through data analysis for improvement and assimilate and translate data into insights. Coordinate data integration activities
      • Partner with IT to set up key data collection and analysis capabilities, as well as patient-facing technology solutions that contribute to program success including personal health records, patient-supplied data, patient portals and other patient-enabling technologies on clinical care.
      • Maintain a working knowledge of applicable Federal, State, and local laws and regulations as well as other policies and procedures in order to ensure adherence in a manner that reflects honest, ethical, and professional behavior. The essential functions listed are not a comprehensive inventory of all duties, tasks, and responsibilities. Employees may also perform other duties as assigned. All employees must work in accordance with our Mission, Vision, and Values of Compassion, Trust, Quality, Innovation, and Teamwork. Employees must abide by all of our standards of patient care, patient's rights and ethical treatment, and adhere to safety and quality programs.

        • Requires experience with clinical documentation
        • Experience in areas such as performance-based healthcare payment models, integrated care delivery models, and/or healthcare provider operations.
        • Requires familiarity with risk stratification methodologies including ACG and HCC
        • Demonstrated general business acumen including understanding of market dynamics, financial/budget management, data analysis and decision making.
        • Proven ability to lead the design, development and implementation of process, structure, tools and measurement indicators that drive operational results.
        • Demonstrated experience leading, complex business transformation and/or system implementation. Ability to drive teams to achieve project deliverables related to quality, cost and timeliness.
        • Demonstrated expertise in change-management leadership and getting buy-in from the front lines of care delivery Education & Experience:

          • Bachelor's Degree Required - Post-graduate qualification, MBA, MHA, Masters in Economics, Population Health or Math is preferred..... click apply for full job details

Keywords: i4 Search Group, San Jose , Vice President, Integrated Care Delivery - Comprehensive Kidney Care C, Executive , San Jose, California

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