Director, Enhanced Care Management

The Director of Enhanced Care Management is responsible for directing and overseeing operations of the enhanced care management program. This includes responsibility for Cal AIM program performance, provider and community collaboration/engagement, oversight of the care management specialists, policy development, process improvement/program enhancements, managing interdependencies and risks, and developing growth opportunities. The director works on projects from the point of conceptualization up to the implementation stages, and is responsible for resolving complex problems. The director supports the VP of Clinical Operations in the development of strategy that results in better health quality outcomes, better patient care, and lower cost of care.

The Director of Enhanced Care Management will develop, implement, supervise, and manage Vynca’s Enhanced Case Management Program. They will supervise Clinical Managers, Clinical Consultants and Lead Care Managers. This individual will be responsible for administering the ECM program, developing linkage with healthcare plans, outreach, creating clear and easy access and entry into the ECM program, program evaluation, and staff supervision.

At this time we are only considering applicants in the following states: Arizona, California, Colorado, Illinois, Nevada, Oregon, Texas, Utah, and Washington.

Refine and implement program policies and procedures

Supervise Clinical Managers, Lead Care Managers, and Support Staff

Oversee day to day ECM program

Ensure that ECM contract goals and objectives are met

Ensure contract regulatory and data requirements are met

Ensure records (electronic and physical) and billing requirements are kept up to standards

Oversee assessments, intakes, care planning, crisis management, transition plans

Oversee and ensure staffing and staff training

Run EHR reports as needed

Oversees claims submission, denials, and receipt of payments

Attends meetings and represents the organization with the public, local businesses, employers, health plans, vendors, regulatory and outside vendors

Provides reports to management and managed care plans regarding ECM as needed

Responsible for CalAIM program performance and successful execution of all SLAs.

Oversee all aspects of running an efficient team, focusing on role definition and attainment of goals

Design and implement standard operating procedures and workflows for the department

Develop strategic messaging that conveys the company’s value proposition and overcomes patient objections

Manage quality assurance programs to enhance the client experience

Develop KPIs that align team member performance to business objectives

Manage P&L and report accurate business results in monthly operations reviews

Apply creative, analytical solutions to business problems, with the ability to remain nimble and pivot quickly when needed

Collaborate with other department leaders and foster cross functional cooperation, especially with business development for referral management and clinical operations for patient on-boarding

Exemplify company culture by modeling core values of the organization and ensuring staff understands values and mission

Other related duties as assigned

The hiring process for this role may consist of applying, followed by a phone screen, online assessment(s), interview(s), an offer, and background/reference checks.

Background Screening: A background check, which may include a drug test or other health screenings depending on the role, will be required prior to employment.

Job Description Scope: This job description is not exhaustive and may include additional activities, duties, and responsibilities not listed herein.

Vaccination Requirement: Employees in patient, client, or customer-facing roles must be vaccinated against influenza. Requests for religious or medical accommodations will be considered but may not always be approved.

Employment Eligibility: Compliance with federal law requires identity and work eligibility verification using E-Verify upon hire.

Equal Opportunity Employer: At Vynca Inc., we embrace diversity and are committed to fostering an inclusive workplace. We value all applicants regardless of race, color, religion, age, national origin, ancestry, ethnicity, gender, gender identity, gender expression, sexual orientation, marital status, veteran status, disability, genetic information, citizenship status, or membership in any other protected group under federal, state, or local law.

Environmental Conditions and Physical Requirements: Works with Vynca patients/clients remotely and/or in-person. Successfully performs the essential duties and responsibilities of the position through the use of physical activities as described below: Regularly requires sitting, standing, walking, talking, use of hands, listening, and observing. Regularly requires working at a computer for an entire shift (with appropriate breaks). Regularly requires use of laptop and video-conferencing technology. Occasionally requires reaching, stooping, bending, kneeling, and lifting items weighing 25 pounds or less. Occasional travel may be required to perform job duties, attend training, or company events.

Regularly requires sitting, standing, walking, talking, use of hands, listening, and observing.

Regularly requires working at a computer for an entire shift (with appropriate breaks).

Regularly requires use of laptop and video-conferencing technology.

Occasionally requires reaching, stooping, bending, kneeling, and lifting items weighing 25 pounds or less.

Occasional travel may be required to perform job duties, attend training, or company events.