Responsible for the relationship between the Care Management Clinical Operations Group and the Clinical Strategy Group. Primary duties may include, but are not limited to: Is the operational subject matter expert for Care Management Programs/Products, working with the Clinical Strategy team and other WellPoint business areas to address their needs within the Care Management delivery system and to ensure that the services delivered are consistent, integrated across the delivery sites and delivers the planned outcomes and results. Works with Clinical Strategy and Analytic teams to ensure that the programs within their scope are being executed across the delivery network as designed and are delivering the performance anticipated in the design. Identify where gaps exist. Responsible for operationalizing pilots and/or new program enhancements/models. Develop plans to address the gaps and work with Directors of Care Center OPS to ensure that Care Management successfully delivers on the intended results. Represents the Care Management Operations Group on committees and task forces as needed.
Requires a BA/BS, 8-10 years of related health care experience; or any combination of education and experience, which would provide an equivalent background. Masters degree in health or business related field preferred. Knowledge of Care Management operations, the programs offered and how they work and/or clinical background preferred. Ability to travel required.
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