VP, Care Coordination-SCAL

This position provides strategic leadership for developing and implementing a cross-continuum care coordination/case management strategy and plan for KP Southern California. This plan includes assessment, implementation, management, and oversight of a scalable, integrated, and patient focused care coordination and case management programs. The desired KP program will leverage technology and other system solutions to address the needs of our members in areas that may include: the physical, behavioral and social non-medical needs. The development of this plan will be completed by partnering with medical group, health plan and hospital leaders across the health care continuum. The Vice President also leads the strategy, development, and implementation of the regional approaches to address the social determinants of health of KP members and patients to ensure they are integral and integrated into the plan of care. This will be accomplished leading our KPSC efforts with Thrive Local, Care Without Delay, and Care Transitions/Case Management.

• Responsible for assessing the SCAL region’s existing Care Coordination and Case Management programs, conducting market scans to identify best practices/care delivery models to identify successful models to inform the strategy and plan for KP’s Care Coordination and Case Management delivery models.


• Responsible for identifying the key Care Coordination and Case Management capabilities, these include but are not limited to: staffing, technology support, and the business and care delivery infrastructure required to develop and implement scalable and compliant care coordination and case management programs.


• Lead the team responsible for developing the strategy and implementation plan of the SCAL regional approaches within the care coordination and case management systems to address the social determinants of health and non-medical needs of KP members and patients to ensure an integrated plan of care. This work will be done in partnership with medical group, health plan and hospital leaders. Responsible for understanding and measuring the quality, experience, affordability performance of the care coordination and case management programs, systems and process to support operations leadership to achieve clinical, financial and member satisfaction goals.


• Oversee and direct regional Complex Case Management and services including plan, program design, and implementation of care models. Accountable for the quality, experience, compliance, and affordability regional program’s performance.


• Serve as Regional lead for regional and enterprise-wide implementation effort to address social non-medical needs via community-based networks. The Thrive Local program will be implemented across SCAL and the enterprise over the next 2 years.


• Lead, guide, direct, and measure performance of the SCAL Care Without Delay program. This program will coordinate care to ensure the right location, right provider, right level of care, and right time for the care to be provided. The CWD program is the primary program to ensure safe, reliable, and accessible patient through put across our delivery system.


• Co-leading with Medical Group to provide oversight for SCERSC – Southern California Resource Stewardship Committee to advice, counsel, and recommendations for all SCAL KFH/HHP and SCPMG Medical Center and Regional operations, quality, and affordability activities.

Qualifications:

• Minimum ten (10) years relevant and progressive management experience

• Bachelors degree in nursing, health services or business administration, public health, finance or related discipline such as public administration.

• N/A

• Demonstrated ability to plan, implement, evaluate and course correct processes and systems that deliver health care services
• Knowledge of financial management
• Ability to demonstrate communication, presentation, leadership, analytical and problem-solving skills
• Demonstrated ability to lead and manage change using interpersonal skills such as negotiating, collaborating, influencing
• Working knowledge of quality assurance, resource management, health plan regulatory and licensing processes.
• Demonstrated ability to achieve results on both a strategic and operational level
• Demonstrated expertise in project management.
• Must be able to work in a Labor/Management Partnership environment.

• Masters degree preferred in one of the disciplines.