ED, Hospital Care Coordination
The ED, Hospital Care Coordination provides leadership, direction, and oversight of all continuing care activities in the hospital/inpatient setting. This position serves in a key leadership capacity for an optimal approach to the management, delivery and value realization of strategic initiatives related to the efficient and effective care coordination for KP members served in hospitals. The position is accountable for implementing initiatives that ensure care without delay standards and processes are consistently delivered for desired optimal results. The role works closely with and coordinates with national and regional executives to provide project/program management delivery, consulting, performance improvement, change management and business analytic support for program wide strategic initiatives that positively impact the organization. This position is responsible for establishing efficient and organized processes to support excellent quality and service. Partners with other leaders from the Health Plan and MAPMG to ensure execution of program goals and key performance indicators.
This position has primary accountability for developing and implementing the philosophy, strategic goals, and objectives for the care management/care coordination functions across settings of care that meet clinical, financial, and regulatory requirements of the markets. This position also provides leadership, oversight, and coordination of care across hospital and post acute, skilled nursing and long care term care settings and partners with ambulatory care coordination and care programs including Medicare, Medi-Caid, and NCQA required programs to address the holistic needs of our members and ensure they are getting the right care, at the right place, and at the right time. This position consistently supports compliance and the Principles of Responsibility (Kaiser Permanentes Code of Conduct) by maintaining the privacy and confidentiality of information, protecting the assets of the organization, acting with ethics and integrity, reporting non-compliance, and adhering to the applicable federal, state and local laws and regulations, accreditation and licenser requirements (if applicable), and Kaiser Permanentes policies and procedures.
- Leads the development and enterprise-wide implementation of strategies to improve acute care coordination and reduction of hospital admissions, ensuring benefit realization through improved quality outcomes, efficiency, and timely transitions of care.
- Drives execution of complex, cross-functional programs that enhance care without delay performance and related outcome measures.
- Designs and implements workflows and processes that promote smooth transitions from inpatient settings, supporting the right care in the right venue at the right time.
- Organizes and leads multidisciplinary teams to advance strategic goals and improve care coordination across the continuum.
- Develops and manages strategic partnerships with hospital partners, providers, external vendors, and internal stakeholders to support care delivery goals.
- Collaborates with Continuing Care, Care Delivery, Health Plan, and MAPMG leaders to align on quality, cost, and operational strategies for inpatient care.
- Manages budget performance and implements cost-effective strategies to improve care quality and service delivery.
- Minimum ten (10) years of progressively relevant clinical or healthcare management experience.
- Bachelors degree in nursing, Health Services, Business Administration or Public Health/Administration.
- N/A
- Extensive experience within the continuum, including but not limited to hospital, skilled/ post-acute, ambulatory, care coordination, and resource stewardship operations Strong understanding of data analytics, healthcare, population health, medical delivery, and medical management; robust understanding of industry trends and best practices.
- Demonstrated knowledge and experience with Medicare and Medicaid managed care, NCQA, TJC and other regulatory requirements
- Experience in consulting and leading multidisciplinary projects and teams with consistent record of achieving results. Includes skills and experience in process architecture, change management, and performance management.
- Excellent communication and presentation skills, both written and verbal, along with executive level interpersonal skills and the ability to work within a matrix environment.
- Strong and demonstrated experience with leading with best practices and proven methodologies for process improvement, scalability, and automation to support long-term growth objectives.
- Masters degree in nursing, Health Services, Business Administration or Public Health/Administration preferred
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