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Regional Director, Clinical Operations

UpwardHealth

Remote
  • Job Type: Full-Time
  • Function: Clinical Research
  • Industry: Healthcare
  • Post Date: 06/23/2022
  • Website: upwardhealth.com
  • Company Address: Rising Sun Mills, 188 Valley Street, Suite 201, Providence, RI, 02909

About UpwardHealth

Upward Health is a home-based medical group specializing in primary medical and behavioral care for individuals with complex needs.

Job Description

Regional Director, Clinical Operations

Upward Health is a home-based medical group specializing in primary medical and behavioral care for individuals with complex needs. We serve patients throughout their communities, and we diagnose, treat, and prescribe anywhere our patients call home. We reduce barriers to care such as long delays due to scheduling. We see patients when they need us, for as much time as they need, bringing care to them. Beyond medical supports, we also assist our patients with challenges that may affect their health, such as food insecurity, social isolation, housing needs, transportation and more. It’s no wonder 98% of patients report being fully satisfied with Upward Health!

Why Is This Role Critical?

The Regional Director, Clinical Operations is a senior leader responsible for consistent delivery of clinical services throughout a designated region, comprised of one or more markets and/or clients. The Regional Director, Clinical Operations implements, monitors, and oversees clinical services to deliver best in class care. This position leads the clinical team across the region to achieve optimal clinical, quality, and financial outcomes. They also analyze regional and market data, identify trends, determine root cause issues, develop work plans, and organize cross-functional teams to achieve market, regional, and corporate goals.

The Regional Director of Clinical Operations reports to the VP, Clinical Operations and works closely with the Chief Clinical Operations Officer to ensure the clinical model is implemented consistently throughout the company. Specifically, this position acts as a liaison by leading efforts to optimize care delivery and care coordination by ensuring services are delivered in a manner consistent with Upward Health’s clinical model. This position closely collaborates with leadership throughout the organization, at the corporate and local level, to optimize consistency in operationalizing the clinical model to drive optimal outcomes within the region. The Regional Director, Clinical Operations works collaboratively with Medical and Clinical Services leadership to refine and evolve the clinical model for the entire organization, considering industry trends and implications locally, as well as nationally. The Regional Director, Clinical Operations leads clinically diverse teams, supporting the culture of Upward Health throughout the regions while maintaining and monitoring compliance with regulatory and payer requirements.

The ideal candidate must be flexible and willing to work in an early-stage company delivering an innovative clinical model and program where the scope of services and protocols will evolve. This will be a dynamic environment that requires flexibility, dedication, and commitment to improve care for underserved and highest risk populations.

 

KEY RESPONSIBILITIES

  • Provides leadership and direction for the Care Team members of each market and assigned region to go deep to build effective working relationships with providers and partnerships with local organizations to deliver culturally competent, best in class care, while maintaining consistency in operationalizing clinical services
  • Acts as liaison between corporate and the markets to ensure successful and consistent execution of clinical services
  • In collaboration with Medical and Clinical Services leadership at the corporate, regional and market level, defines and refines clinical services to evolve the clinical model; responsible for successful implementation and operations to achieve clinical, quality, and financial goals
  • Measures clinical operations effectiveness through monitoring and managing to KPIs and leading indicators, and takes steps to ensure continuous performance improvement in outcomes
  • In collaboration with the key leadership at the corporate, regional and market level of the organization, develops clinical, quality, and financial metrics for the region
  • Represents the organization during initial and ongoing client meetings as the key point of contact for all assigned clients across the assigned region; Managing the client relationship through the review of utilization, clinical, quality outcomes and delivering remediation plans for those measures and metrics below expected targets
  • Supports product and service expansion across markets
  • Develops and fosters the Upward Health culture amongst the Clinical Service team as well as with other areas, promoting an atmosphere of engagement, trust, and open dialogue
  • Develops talent within team to build bench strength within the organization; ensures the clinical operations team has the tools and the skills necessary to execute the clinical model delivery
  • Ensures strict compliance with federal and state regulations and company policies, procedures, and processes

 

KNOWLEDGE, SKILLS & ABILITIES

  •      Leadership experience in a clinical operations environment and management of a significant P&L
  • Demonstrated organizational agility; able to manage up and manage down, acting as a liaison to drive strategy and achieve organizational goals
  • Demonstrated track record of building high functioning teams that produce successful outcomes
  • Ability to effectively analyze data, make decisions and implement recommendations for improvement in a fast-paced environment
  • Strong focus on culture, employee engagement, and performance management, with the ability to attract, manage and develop staff of unmatched quality
  • Experience creating and implementing clinical service models that add value to physician practices
  • Interpersonal savvy, demonstrated by the ability to interact with and influence clients at all levels
  • Entrepreneurial and operational mindset to create, execute, and measure from the ground up with a high sense of urgency
  • Excellent written, computer, and oral communication skills – will proactively and thoroughly communicate with other members of the team

 

MINIMUM QUALIFICATIONS

  • Bachelor's degree in Nursing, or health related field of study required
  • Significant experience working with and understanding community-based care, SDOH and behavioral health
  • Must have three (3) years of experience in clinical operations (managed care), or direct clinical services within a large provider group in an outpatient setting (i.e.: ACO, FQHC)
  • Must have five (5) years of management experience required
  • Strong working knowledge of Medicare and Medicaid structure and member population needs
  • Experience with quality metrics for value-based care payment models preferred
  • Experience with EMR and healthcare technology required

 

PREFERRED QUALIFICATIONS

  • Master's degree preferred

 

This job description is a general outline of duties performed and is not to be misconstrued as encompassing all duties performed within the position. All individuals (including current employees) selected for a position will undergo a background check appropriate for the position's responsibilities.

 

**We require all employees to be vaccinated for Covid, and be able to show proof upon hire **

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