At APS Healthcare, we are passionate about changing behaviors of all constituents in the healthcare system to improve health, optimize clinical quality, and reduce associated costs. Our mission, quite simply, is to improve the health of those we serve. APS is managing the Oregon Health Plan Care Coordination (OHPCC) Program, which supports high-risk clients with chronic illness through disease management and medical care coordination. The program supports providers and assist clients in becoming and staying healthy by reinforcing treatment plans and by educating patients on making responsible decisions about their healthcare.
APS is seeking a Clinical Operations Manager to be a key leader of this exciting program. The successful individual will oversee a team of 17 clinical and non-clinical staff and is responsible clinical service delivery of the contract. Partnering with the Executive Director, the Manager assists in strategic development, coordination, integration, monitoring and evaluation of contracted services. The position is based in the APS Tualatin office and will require some travel as needed.
• Ensures compliance with program requirements of all contracted clinical services including oversight of care management functions, quality initiatives and delivery of evidence-based practices.
• Resource for direct reports including but not limited to: protocols, staffing issues, troubleshooting, conflict resolution (internal and external), work-loads/-flows, productivity and personnel issues.
• Reviews internal and external customer reports for appropriate utilization of services, trends, costs and health outcomes. Provides feedback to Executive Director on a timely basis relative to any identified issues and resolution, and to client as requested/required.
• Directly responsible for recruitment of qualified professionals including orientation and training on processes and systems and continued professional development of existing staff.
• Participates in performance appraisals of onsite and off-site employees including making recommendations for process improvement, employee development and strategies to achieve contractual outcomes.
• Monitors compliance with URAC and relevant regulatory processes.
• Designs and implements departmental policies and procedures including review of relevant workflows and metrics.
• Participates in Provider Outreach and other Business Development activities with client and other local healthcare partners.
• Schedules regular care management and interdepartmental meetings to facilitate cross-functional communication, problem-solving and strategic planning.
• Bachelor’s degree in nursing, health-related field, or healthcare administration
• Master’s degree in business, public administration or health care administration strongly preferred
• Active and unrestricted Oregon RN licensure required.
• Position requires 7 to 9 years of progressive management experience in a healthcare field, including at least 4 years of team leadership experience
• Previous experience in managed care leading a care coordination and/or disease management program preferred
• Familiarity with the Oregon healthcare community and resources
• Experience managing through metrics in a performance based culture
• Knowledge of management processes including planning and organizing, financial management, applicable regulations, and human resource development.
• Able to evaluate reports and pertinent client trends, draw valid conclusions, and exhibit independent judgment in the development and assessment of multiple levels of information.
• Organizational skills and efficiency in prioritizing care management operations.
• Strong verbal and written communication skills.