Director, Assessments and Care Planning

Position Summary:

The Director of Clinical Assessment and Care Planning provides leadership and directs the operations and administration of the clinical assessment and care planning components of the member onboarding and reassessment processes. The role involves planning, organizing, coordinating, and controlling the resources required to ensure timely and high quality MDS assessments and initial care plans. Additionally, it involves managing people, equipment, technology, information, and other resources needed to ensure all members receive timely access to CCA's clinical team and services and to ensure accurate Medicaid capitation rate classification.

The Director, Clinical Assessment and Care Planning is responsible for ongoing optimization of unit operations, including staff productivity, continuous process improvement, efficiency related activities, as well as ensuring cross functional alignment to optimize the member experience. The Director is a member of CCA's Clinical Leadership Team and participates in key planning and ongoing development activities required of leaders across the organization, and in this vein will represent CCA interests and serve as subject matter expert at various client meetings with MassHealth and others.

Supervision Exercised:

• Yes

Essential Duties & Responsibilities:

As a member of CCA's Clinical Leadership Team, the Director participates in key planning, budgeting and ongoing operations management.

The Director is responsible and accountable for:

• Providing leadership and direction to the department focusing on the integration of both the clinical and
• business needs, while being mindful of our contractual obligations.
• Articulating the vision and function of the Clinical Assessment and Care Planning Department to the entire department and organization wide.
• Maintaining an outstanding member onboarding experience and leading all direct reports and their teams, to maintain processes that including clear and appropriate member communication.
• Developing, monitoring, and reporting key performance measures to ensure clear visibility into operational and outcome performance excellence, regulatory compliance and achievement of performance goals related to all aspects of the department's operations.
• Assuring consistent performance monitoring by Managers of departmental teams.
• Monitoring performance results and work with the cross functional team on addressing gaps in performance
• Preparing the annual budget and managing it.
• Developing and maintaining departmental priorities.
• Leading the implementation, and utilization of new or enhanced technologies that support the work of the department and maximize accurate data collection.
• Managing vendor relationships and oversight as needed to support assessment completion and care plan creation
• Developing and maintaining departmental Policies & Procedures, Standards of Practice, and guidance documents.
• Maintaining regulatory compliance by ensuring that the processes and resources needed are in place
• Interfacing with regulators as needed.
• Spearheading organization-wide understanding of the importance of timely, accurate, high quality member assessments
• Spearheading organization-wide understanding of the importance of an open, ever evolving member specific care plan reflecting their unique needs, the interventions provided, members barriers to achievement of goals, and represent these outwardly to stakeholders and clients (MassHealth) and member specific outcomes
• Actively contribute as a member of the Clinical leadership team to organizational goals.
• Facilitate and/or participate in continuous improvement and business process optimizations.
• Lead and/or participate in the development of new programs and innovations

Working Conditions:

• Standard office conditions.

Required Education (must have):

• Bachelor's Degree or equivalent experience

Desired Education (nice to have):

• Nursing License (e.g., RN, NP, etc) strongly preferred
• Master's degree in business or health related strongly preferred

Required Licensing (must have):

Desired Licensing (nice to have):

MA Health Enrollment (required if licensed in Massachusetts):

• Yes, this is required if the incumbent is licensed in Massachusetts.

Required Experience (must have):

• 8+ years' experience leading complex operation and process improvement, including 2 years in healthcare environment

Desired Experience (nice to have):

• Experience in implementing products and services across different markets and different states.

Required Knowledge, Skills & Abilities (must have):

• Leadership experience in both health plan and provider organization settings preferred
• Solid organizational skills and ability to balance multiple priorities in a dynamic environment; ability to drive process improvement.
• Operations management experience required, including development of complex staffing models, productivity
• Plans and preparation of complex budgets.
• Proven track record of developing, monitoring and managing performance metrics.
• Well-developed planning capabilities with a track record of achieving results, controlling costs, setting budgets and meeting deadlines.
• Ability to think critically, drive change and influence individuals at all levels of the organization and to take appropriate risks
• Strong customer service orientation.
• Excellent verbal and written communication skills

Required Language (must have):

• English

Desired Knowledge, Skills, Abilities & Language (nice to have):

• Knowledge of managing member populations within Massachusetts
• Multiple Language Proficiency a plus