Sr Director, Hospital Relations and Inpatient Clinical Support
CalOptima Health is seeking a highly motivated an experienced Sr Director, Hospital Relations and Inpatient Clinical Support to join our team. The Sr Director (Hospital Relations and Inpatient Clinical Support) will be responsible for leading operational effectiveness between hospitals and all CalOptima Health and health network partners. The incumbent will work collaboratively with the Executive Director, Clinical Operations and Deputy Chief Medical Officer to support and coordinate our hospital partnerships, communicating and directing protocols across the entire CalOptima Health delivery of care. The incumbent will be responsible for ensuring patient access through quality outcomes and a system approach to ensure inpatient care, transitional care services and communication amongst treatment teams. The incumbent will lead through a front-line, coordinated approach working with our hospitals, direct providers and health network partnerships to ensure exceptional direction and communication to serve CalOptima Health members.
Position Information:
Department: Utilization Management
Salary Grade: T - $182,000 - $317,152
Work Arrangement: Partial Telework**This position is eligible for telework in California.**
Duties & Responsibilities:
50% - Leadership Functions
Cultivates and promotes a mission-driven culture of high-quality performance, with a member focus on customer service, consistency, dignity and accountability.
Directs and assists the team in carrying out department responsibilities and collaborates with the leadership team and staff to support short- and long-term goals/priorities for the department.
Facilitates improvement planning and escalation discussions with leadership including Executive Team and Chief Medical Officer as appropriate.
Develops and implements effective and standardized communication strategies to facilitate seamless information flow among health care providers.
Promotes a culture of accountability, excellence and continuous improvement with hospital partners through exemplary leadership practices.
Participates and presents in CalOptima Health's committee meetings.
45% - Operational Functions
Contributes to the development of policies and procedures that support effective collaboration for hospital teams and ambulatory care providers within the broader health care community.
Collaborates with Medical Management leadership to align inpatient clinical practices with organizational goals, ensuring high-quality and patient-centered care.
Develops and maintains relationships with acute care facilities to ensure seamless transitions and coordinated care for patients.
Establishes and maintains a strong in-hospital presence, engaging directly with health care providers to understand their challenges and needs priorities and strategic approach to align all CalOptima Health's health networks to a coordinated and streamlined process for hospital partners.
Collaborates with all internal and health network Medical Directors and proactively educates the internal UM department and health network teams as new protocols or requirements and emerge related to hospital partnerships.
Develops and implements strategies for ensuring appropriate protocol communication on methods, Key Performance Indicators (KPI) and success, in information exchange to support consistent and high-quality Transitional Care Services (TCS) for all CalOptima Health members.
Participates in workgroups that address both clinical and non-clinical activities related to Transitional Care services in Utilization management and Care Management.
Participates in Joint Operation Meetings and Hospital Association calls to communicate protocols and report outcomes.
5% - Completes other projects and duties as assigned.
Minimum Qualifications:
Bachelor's degree in health care administration or related field required.
7 years of progressively responsible experience in the health care industry required.
5 years of Acute Care experience required.
5 years of supervisory/management experience in a hospital setting required.
Experience with emergency room operations and coordination required.
An equivalent combination of education and experience sufficient to successfully perform the essential duties of the position such as those listed above may also be qualifying.
Valid driver's license and vehicle or other approved means of transportation, an acceptable driving record and current auto insurance will be required for work away from the primary office 30% of the time or more.
Preferred Qualifications:
Master's degree of science in nursing, health care administration or related field.Experience as chief nursing officer at an acute care facility.
Required Licensure / Certifications:
Current, unrestricted Registered Nurse (RN) or Licensed Vocational Nurse (LVN) license to practice in the State of California required.
Knowledge & Abilities:
Develop rapport and establish and maintain effective working relationships with CalOptima Health's leadership and staff and external contacts at all levels and with diverse backgrounds.
Work independently and exercise sound judgment.
Communicate clearly and concisely, both orally and in writing.
Work a flexible schedule; available to participate in evening and weekend events.
Organize, be analytical, problem-solve and possess project management skills.
Work in a fast-paced environment and in an efficient manner.
Manage multiple projects and identify opportunities for internal and external collaboration.
Motivate and lead multi-program teams and external committees/coalitions.
Utilize computer and appropriate software (e.g., Microsoft Office: Word, Outlook, Excel, PowerPoint) and job specific applications/systems to produce correspondence, charts, spreadsheets, and/or other information applicable to the position assignment.
Physical Requirements (With or Without Accommodations):
Ability to visually read information from computer screens, forms and other printed materials and information.
Ability to speak (enunciate) clearly in conversation and general communication.
Hearing ability for verbal communication/conversation/responses via telephone, telephone systems, and face-to-face interactions.
Manual dexterity for typing, writing, standing and reaching, flexibility, body movement for bending, crouching, walking, kneeling and prolonged sitting.
Lifting and moving objects, patients and/or equipment 10 to 25 pounds
Work Environment:
If located at the 500, 505 Building or a remote work location:
Work is typically indoors and sedentary and is subject to schedule changes and/or variable work hours, with travel as needed.
There are no harmful environmental conditions present for this job.
The noise level in this work environment is usually moderate.
If located at PACE:
Work is typically indoors in a clinical setting serving the frail and elderly.
There may be harmful or hazardous environmental conditions present for this job.
The noise level in this work environment is usually moderate to loud.
If located in the Community:
Work is typically indoors and sedentary and is subject to schedule changes and/or variable work hours, with travel as needed.
Employee will occasionally work outdoors in varied temperatures.
There may be harmful or hazardous environmental conditions present for this job.
The noise level in this work environment is usually moderate to loud.
About CalOptima Health:CalOptima Health is the single largest health plan in Orange County, serving one in four residents. Our motto - "Better. Together." - is at the heart of our mission to serve members with excellence, dignity and respect. We are a public agency made up of compassionate leaders and professionals working together to strengthen our community's health. We are continuing to build a culture that promotes diversity and inclusion within our community where employees have a sense of belonging, and are valued for their ideas, contributions, and their unique individual perspectives they bring.CalOptima Health has been recognized as one of Orange County's best places to work, so we know there is something special about our organization. It is why people choose to work here and why they choose to stay!
About our Benefits & Wellness options:At CalOptima Health, we know that a healthy and happy workforce is a thriving workforce, which is why we offer a comprehensive benefits package, including participation in the California Public Employees Retirement System (CalPERS), low-cost medical/vision/dental insurance options, and paid time off. To support quality work-life balance, we allow flexible scheduling during core business hours, telework options for some positions, work schedules that allow every other Monday or Friday off (9/80 schedule), and a wellness program featuring diverse activities. Additionally, CalOptima Health contributes 4% of pensionable earnings to a 401(a) retirement program with no required employee contribution. For those who are interested in additional retirement savings, employees have access to 457(b) retirement plans with pre/post-tax contribution options.For more information, please click on the 2024 CalOptima Health Benefits Guide regarding our comprehensive benefits and wellness package.
IMPORTANT APPLICATION INFORMATION AND INSTRUCTIONS
Applications will be accepted on a continuous basis until a sufficient number of qualified applications have been received. The deadline for the first review of applications is April 3, 2024 at9:00 PM (PST).Applicants are encouraged to apply early. Applicants that apply after the first review are not guaranteed to be considered for this recruitment. This recruitment may close at any time without notice after the first review date.
The selection process may include, but is not limited to, a skills assessment, phone screen and interview.
The successful candidate will be required to undergo a reference / background check (to include a conviction record) and if applicable also pass a post-offer pre-employment medical examination (which will include a drug screening). Internal CalOptima Health applicants should apply through InfoNet.
Communication regarding your application will be sent to the email address listed on your application. Please check your email, including your SPAM folder, regularly throughout the recruitment process. You can also visit your candidate portal to receive the most up to date status of your application.
To apply, visit:
https://jobs.caloptima.org/jobs/sr-director-hospital-relations-and-inpatient-clinical-support-505-city-parkway-california-united-statesCalOptima Health is committed to attracting, hiring, and retaining a diverse staff, where we will honor your unique experiences, identity, and perspectives. Our organization strives to create and maintain a workplace environment that is inclusive, equitable and welcoming so we can truly be Better Together.
CalOptima Health is an equal opportunity employer and makes all employment decisions on the basis of merit. CalOptima Health wants to have qualified employees in every job position. CalOptima Health prohibits unlawful discrimination against any employee, or applicant for employment, based on race, religion/religious creed, color, national origin, ancestry, mental or physical disability, medical condition, genetic information, marital status, sex, sex stereotype, gender, gender identity, gender expression, transitioning status, age, sexual orientation, immigration status, military status as a disabled veteran, or veteran of the Vietnam era, or any other consideration made unlawful by federal, state, or local laws. CalOptima Health also prohibits unlawful discrimination based on the perception that anyone has any of those characteristics or is associated with a person who has, or is perceived as having, any of those characteristics.
If you are a qualified individual with a disability or a disabled veteran, you may request a reasonable accommodation at (714) 246-8400 if you are unable or limited in your ability to access job openings or apply for a job on this site as a result of your disability.
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