Director, Ancillary Relations

What you can expect! 

Find joy in serving others with IEHP! We welcome you to join us in “healing and inspiring the human spirit” and to pivot from a “job” opportunity to an authentic experience!

This position supports department Senior Leadership in leading a team of operational, process, and clinical improvement professionals to drive improvements through a portfolio of strategic projects. The Director, Ancillary Relations promotes a culture of continuous improvement through the use of improvement methodologies, data analysis, reliability, sustainability and spread. The incumbent translates clinical, operational, quality, safety, and experience data into meaningful information and clearly communicates critical information to leadership and other stakeholders to improve performance and decision making. The Director partners with stakeholders to create a shared operational and strategic direction. This position provides high quality project management and analysis for a broad array of clinical and operational issues. Applies health system-specific expertise, industry best practices and knowledge of internal and external performance challenges to recommend improvements. Partners with department leadership in acting as a communication conduit between IEHP and local ancillary facility/agency executive leadership for performance improvement in treating IEHP members. Under the direction of department senior leadership, the Director, Ancillary Relations will have a key role in achieving the IEHP Optimal Care Goals and Strategies that are driven by or influenced by our provider ancillary facilities (i.e., skilled nursing facilities, congregate living health facilities, etc.) and agencies (i.e., home health, hospice, etc.)

Commitment to Quality: The IEHP Team is committed to incorporate IEHP’s Quality Program goals including, but not limited to, HEDIS, CAHPS, and NCQA Accreditation.

Perks

IEHP is not only committed to healing and inspiring the human spirit of our Members, but we also aim to match our team members with the same energy by providing prime benefits and more.

• Competitive salary.
• Hybrid schedule.
• State of the art fitness center on-site.
• Medical Insurance with Dental and Vision.
• Life, short-term, and long-term disability options
• Career advancement opportunities and professional development.
• Wellness programs that promote a healthy work-life balance.
• Flexible Spending Account – Health Care/Childcare
• CalPERS retirement
• 457(b) option with a contribution match
• Paid life insurance for employees
• Pet care insurance

1. In collaboration with department senior leadership, work with ancillary leadership teams, SNFists, clinical champions, and frontline staff in ancillary and health plan settings to:
   • Lead Joint Operations Meetings and associated workgroups.
   • Utilize clinical analytics to make health/quality management recommendations to IEHP and ancillary stakeholders.
     • Through data review and analysis, recommend selection of performance metrics to be proposed to senior leadership for organization-level priorities, with special consideration made to ensure that all programs are based on reliable data, clinical evidence, operational realities, provider bandwidth, payer trends and anticipated changes in the healthcare environment.
   • Based on recommendations driven by clinical analytics, develop implementation strategies/project plans that include change management tactics for approval and successful execution of programs or processes that better serve our members.
   • Execute on approved plans, provide daily monitoring and oversight including progress status reports to track progress of Optimal Care projects and quality of care and services, and financial outcomes.
   • Collaborate with Quality to institute processes for continuous evaluation of trends related to quality measures, clinical and operational program performance; identify and act on opportunities for improvement while considering cost of quality.
   • Engage in daily operational engagement efforts to ensure cross functional readiness/change management adoption, considering people, process, and technology when introducing new policies or services and optimizing existing processes or capabilities.
   • Drive daily issue resolution requiring detailed information gathering, analysis and investigation; provide recommendations and immediate decision making as needed.
   • Research best practices and reviews policies and procedures for opportunities to enhance performance outcomes.
2. Direct and prioritize the activities of the process and clinical improvement professionals leading and facilitating health plan and ancillary strategic operational, quality, safety, and efficiency collaborative improvement projects.
3. Engage performance improvement teams both at IEHP and ancillary providers to reduce gaps in care delivery and unnecessary practice variation that negatively impacts optimal care to lead towards an integrated system of care to ensure high value care for members.
4. Support optimal care workgroups to implement cross functional initiatives intended to drive performance improvement. Responsibilities include, but are not limited to:
   • Acting as a Project/Workgroup Leader as needed especially in those groups that are determined by department senior leadership to have clinical complexity.
   • Functioning with a continuous improvement mindset, actively seeking enhancements to the current state and/or creation of new programs or processes to meet organizational priorities.
   • Leveraging clinical setting background, subject matter expertise and understanding of hospital and healthcare operations to influence and assist partners in the identification and implementation of innovative models and best practices with an emphasis on quality of care, service improvements and cost reduction.
   • Collaborating with stakeholders to develop creative solutions or enhancements to solve operational issues, address barriers to care and improve compliance with IEHP requirements.
   • Collaborating with IEHP leadership to evaluate and develop the business case for new solutions or program enhancements. 
   • Identifying areas of focus, design and execute on IEHP approved solutions or programs to meet performance improvement goals and strategic plans.
   • Leading program design, in collaboration with other stakeholders, and implementation with focus on clinical solutions that impact member outcomes, experience, and satisfaction.
   • Developing work plans, workflows, policies, and procedures; monitoring progress towards goals. 
   • Supporting the design of best practice methodologies and disseminating information through communication channels, job aids, training, and resource materials.
   • Collaborating with appropriate partners to assess health management vendors for possible inclusion in recommended programs.
   • Supporting change management initiatives, encouraging innovative approaches, building support and partnerships for transformation
5. Provide support to Ancillary Providers, including associated clinical Providers, with quality improvement activities.
   • Work with payer-provider partners to realize shared objectives, support strategy and goal initiatives, drive improvement plans and measure outcomes in both quality of care and member experience
6. Support department senior leadership in:
   • Working closely with the IEHP Compliance and Legal Department to ensure Ancillary Provider and associated clinical Provider compliance with regulatory agencies, IEHP Policies and Procedures, and IEHP legal requirements.
   • Identifying and strengthening strategic partnerships with Inland Empire Ancillary Providers and Health Systems regarding their quality initiatives and patient satisfaction surveys, including the development of hospital and/or ancillary quality report cards.
   • Obtaining, reviewing, and analyzing reports including key performance indicators and risk areas to identify trends and ensure all responsible parties are aligned and driving towards shared performance goals.
   • Maintaining effective business relationships with Ancillary Providers and Health Plan leadership, external client decision makers and vendor business partners.
   • Creating presentations for various levels of management depending on audience and deliverables.
7. Manage staff and department operations such as:
   • Providing input into staffing decisions, budget development and monitoring.
   • Ensuring appropriate financial, professional and time management stewardship in all assigned programs.
   • Directing department staffing plan, applicant selection, new hire orientation.
   • Maintaining updated job descriptions, communicating performance expectations and job duties with direct reports.
   • Assessing, developing, and coaching process and clinical improvement professionals in performance improvement implementation strategies in support of the strategic goals in order to foster employee performance, knowledge, skills, job progressions, workload and job specific expertise.
8. Perform any other duties as required to ensure Health Plan operations and department business needs are successful.

Education & Requirements 

• Eight (8) years of relevant progressive operational experience in a clinical setting paired with leadership experience within a Hospital, Ancillary, or Healthcare System
• Five (5) years of experience implementing and leading hospital and/or ancillary process improvement/quality initiatives, quality management programs, patient safety, and clinical education
• Five (5) years of experience in leveraging data analytics to aid in driving innovation
• Experience in both leader and support roles within hospital systems or healthcare organizations
• Master’s degree in business, healthcare, or related field from an accredited institution required.
  • In lieu of a Master’s degree, a Bachelor’s degree in Business, Healthcare, or related field from an accredited institution and a minimum of four (4) years of additional combined hospital, ancillary and/or health plan experience is required for this position
  • This experience is in addition to the minimum years listed in the Experience Requirements above
• Certified Professional in Healthcare Quality (CPHQ) required within one (1) year of hire (maintained through employment)
• Possession of an active, unrestricted, and unencumbered clinical license required in one (1) of the following areas:
  • Registered Nurse (RN) license issued by the California BRN
  • Another ancillary license issued by the appropriate licensing board
  • In lieu of clinical license, a minimum of five (5) years of broad-scope operational experience at the Director level. This experience can be part of the Experience Requirements above
• Possession of an active, unrestricted, and unencumbered Nursing Home Administrator (NHA) license issued by the California Department of Public Health preferred

Key Qualifications

• The ideal candidate is passionate about driving improvements in care delivery, has a clinical setting background with significant hospital/healthcare operations and quality management knowledge, effective in complex health care environments, and confident in interactions with senior leaders, clinicians, and business partners
• Strong knowledge in the following areas:
  • Hospital and/or Ancillary quality initiatives
  • Operational issues relevant to Hospitals and/or Ancillary providers
  • Process Improvement
  • Patient Safety
• Technical (clinical setting) skillset
• Education/Training skills. Leadership, planning and organization
• Written and verbal communication skills. Presentation skills to all levels
• Critical thinking, analytical, and problem-solving skills
• Project Management processes and methodologies
• Microsoft Office (Word, Outlook, Excel, PowerPoint)
• Proven ability to:
  • Embrace and exemplify the IEHP Mission, Vision and Values
  • Lead and motivate staff to produce quality work product within tight timeframes while simultaneously managing multiple projects
  • Balance multiple high stakes projects/tasks in a high paced and busy environment while meeting deadlines
  • Work independently and develop business operations and processes
  • Be detail oriented with exceptional follow through and tracking
  • Cultivate and maintain effective working relationships with internal and external partners from various socioeconomic, ethnic, and cultural backgrounds
  • Show tenacity and objectivity in leading change toward an effective work environment

Start your journey towards a thriving future with IEHP and apply TODAY!

This position is on a hybrid work schedule. (Mon & Fri - remote, Tues - Thurs onsite in Rancho Cucamonga, CA.)