Director of Network Integrity and Care Navigation

All the benefits and perks you need for you and your family:

• Benefits from Day One
• Paid Days Off from Day One
• Student Loan Repayment Program
• Career Development
• Whole Person Wellbeing Resources

Our promise to you: Joining AdventHealth is about being part of something bigger. It’s about belonging to a community that believes in the wholeness of each person, and serves to uplift others in body, mind and spirit. AdventHealth is a place where you can thrive professionally, and grow spiritually, by Extending the Healing Ministry of Christ. Where you will be valued for who you are and the unique experiences you bring to our purpose-minded team. All while understanding that together we are even better.

Schedule: Full-time

Shift: Day

The community you’ll be caring for:

• Join a team that provides exceptional patient-based care
• Collaborative teams that work together for a common goal
• Compassionate and supportive leaders ensure work life balance for team members and providers without compromising patient care

Location: 900 HOPE WAY, Altamonte Springs, 32714

The role you’ll contribute:

The Director of Network Integrity and Care Navigation works with PHD-PCP directors and senior leadership teams to implement and operationalize network integrity and care navigation related initiatives and strategies that are in harmony with AdventHealth’s strategic plan and priorities for value-based care. The Director of Network Integrity and Care Navigation has full accountability and oversight for the overall operations of the Care Navigation team. As such, the Director will be responsible for creating a patient navigation function/team which will be accountable for tracking patient compliance and engagement throughout the continuum of care, connecting with the patient once a referral has been made, and assist with appointment coordination for specialist provider visits. The Director will have responsibility to ensure our PCPs, networks, and patients have appropriate and timely access to our specialty providers upon the execution of a referral. The Director will be responsible for sustaining and improving population health related initiatives such as: network integrity/development, risk readiness, and maintaining a high value specialty network. The Director leads engagements with key stakeholders while working hand in hand with PHSO and AHMG teams to identify and target physicians that deliver high-value integrated care throughout their division/markets that can be utilized by PHD-PCP. The Director will be considered an expert in identifying opportunities and enhancing physician performance in complex delivery systems. The Director must have a passion for delivering high-quality and high-touch service to our community and have a genuine commitment to maintaining positive physician relations. The Director partners with PHD-PCP business operations leaders and works hand in hand to create a seamless handoff that ultimately enhances patient engagement through our referral and navigation process. The Director must be high energy, committed to producing individual results, and possess drive and desire to work in a fast-paced, high-growth, team-based environment. The Director accepts responsibility in maintaining relationships that are equally respectful to all.

The value you’ll bring to the team:

Within PHD-PCP:

• Works hand in hand with PHD-PCP leadership to grow, maintain and enhance network integrity and care navigation related initiatives that include but are not limited to the following:

• Directs the daily operations of the Care Navigation department, including all aspects of referral team handoff, tracking of patient referral compliance, and appointment coordination.

• Responsible for providing and or implementing strategies to improve operations and outcomes.

• Determines proactive strategies and methods necessary for a high-performance culture related to Network Integrity and Care Navigation.

• Assists in the development and oversees the implementation of Care Navigation policies, procedures, and standards.

• Leadership oversight in the following areas: Network Integrity/Development, Network Operations, and Provider Performance.

• Oversee value-based program administration and provide vision/ leadership to align clinicians, health plan leadership and administration efforts throughout the care continuum.

• Provide strategic leadership and work collaboratively with internal stakeholders to develop tactical road maps portraying short- and long-term goals of the PHD-PCP network integrity and care navigation team.

• Provide leadership and assistance with the identification of populations, needs, and trends that may impact outcomes, experience, and cost of care through in-depth analyses and prioritization of strategies that drive clinical transformation.

• Participates in the development of new staffing for referral/patient navigation that support system goals while achieving best in class performance.

• Communicates and collaborates across the PHD business operations and clinical teams in the areas of care navigation, referral coordination, and patient compliance.

• Build a team of managers and front-line employees committed to all aspects of care navigation.

• Works closely with PHD-PCP leaders and teams to ensure strategic and operational alignment.

• Works collaboratively with leaders of to efficiently address any Care Navigation/patient compliance concerns and escalates appropriately and timely.

• Partners with other Division/Regional Network Development Leaders (PHSO and AHMG) for state or systemwide strategic provider partnerships in specialty care, ancillary care, and acute and emergency department care.

• Participates in key committee meetings and provides leadership and expertise regarding care navigation/referral initiatives.

• Provide direct responsibility for leading and coordinating the efforts of the organization to move from a fee-for-service reimbursement methodology to a value-based payment environment with an emphasis on population health management.

• Responsible for creating a patient coordination function that integrates with the referral team process and makes for a seamless handoff from the referral team to the navigation team.

• Recommends actions, negotiates, and assists in managing physician and non-physician relationships within the network.

• Utilizes market intelligence and data to determine the size and scope of the team required to deliver high quality care navigation services that meet the needs of the communities we serve.

• Responsible for appropriately identifying, researching, analyzing, recommending, and executing on care navigation strategies and initiatives.

• Oversees the effectiveness of the department’s recruitment and retention program, taking action as necessary to provide an adequate level of qualified staff.

• Assists Executive Director of Network Integrity with operating budget for Network Integrity and Care Navigation.

• Maintains professional growth and development through seminars, workshops and professional affiliations to keep abreast of latest trends in the health care industry and in Care Navigation and clinical integration, specifically.

• Completes other projects as assigned.

The expertise and experiences you’ll need to succeed:

EDUCATIONANDEXPERIENCEREQUIRED:

• Bachelor’s degree in Business, Healthcare Administration, Nursing, or a related field

• Minimum three years’ experience in strategy/business development, public relations, marketing, and/or finance

• Minimum two years’ leadership experience (direct oversight of FTE’s and/or organizational strategies)

• Minimum two years’ experience in healthcarestrategy, operations, and/or finance.

• 3 years of Manager level (or above) experience in Care Navigation/Coordination

EDUCATIONANDEXPERIENCEPREFERRED:

• Registered Nurse: BSN or Social Worker: LCSW preferred

• Master’s degree in Business or Healthcare Administration preferred

• Five years of experience in healthcare strategy

• Five years of experience in executive leadership in healthcare

LICENSURE,CERTIFICATIONORREGISTRATIONREQUIRED:

• N/A

LICENSURE,CERTIFICATIONORREGISTRATIONPREFERRED:

• Registered Nurse: BSN or Social Worker: LCSW