Manager, Care Management -Outpatient Services

About Our Company

At Altais, we’re looking for bold and curious clinicians and innovators who share our passion for enabling better health care experiences and revolutionizing the healthcare system for physicians, advanced care providers, patients, and the clinical community. At Altais, we’re building breakthrough clinical support tools, technology, and services to let doctors do what they do best: care for people. We invite you to join our growing passionate team as we change the game for the future of healthcare and enable the experience that people need and deserve. Altais family of companies include Brown & Toland Physicians, Family Care Specialists and Altais Medical Groups.

About Your Team

Are you looking to work with a high performing, fast growing and dynamic Health & Innovation team? We are 4,000+ physicians, working in over 40 cities throughout California, caring for more than 500,000 patients. If you are passionate about reshaping healthcare and want to work for a mission driven organization where new ideas and innovation are valued, then we would like to meet you.

About Your Work

The Care management team is looking for a leader with Care Management experience who can help design and lead our existing Care Management Programs and future innovative population health programs for all lines of business. The Manager of Care Management will report to the Vice President, Enterprise Health Services & Quality. This will have responsibilities to include Model of Care development for D-SNP members and oversight of other lines of business. This will require a rigorous oversight of all regulatory aspects of care management

You will focus on:

• Partner with senior leadership to develop and implement annual strategic planning, resource planning to ensure appropriate resources are allocated to projects and are appropriately calculated in the care management department budget.
• Acts as a change agent in order to improve performance results, provides organizational effectiveness leadership to achieve department goals (people/process/technology).
• Responsible for the care management team that focuses on high quality patient care and other high member touch programs.
• Establish strong partnerships across the organization including People & Engagement, Finance, Enterprise Project Management Office, and IT.
• Collaboratively works across multiple business areas to obtain agreement from all impacted parties when addressing cross functional organizational problems.
• Coordinate care management team readiness for new program implementations with the goal of ensuring all members have access to the right care, at the right time, and at the right benefit at the right price on their effective date and all operational metrics are within agreed upon service levels.
• Develop and maintain a training and learning development plan. Ensures ongoing business process management using continuous process improvement practices, and implementation of technology to drive greater efficiency, productivity and customer experience.
• Is responsible for driving the strategic outcomes of the Care Management programs. This includes the evaluation of data from multiple sources, designing programs in conjunction with other clinical leaders, and reviewing the results from key performance indicators. Is responsible for partnering with Senior Markets to create, design and implement key initiatives that will enhance the profitability of this product by developing products, services, processes or systems that are new to the organization.
• Responsible for key Care Management metrics related to compliance and contractual obligations by ensuring teams are within compliance in accordance to regulatory requirements.
• Develop prospective approach to maintaining audit readiness. Serves as representative of Care Management department for areas of responsibility.
• Subject matter expert in all regulatory and process related areas of Care Management.
• Maintains staffing and development of Care Management team.
• Works cross functionally to start new Care Management initiatives.
• Leads the identification and operationalization of initiatives.
• Reviews results from key performance indicators and adjusts accordingly.

The Skills, Experience & Education You Bring

• Current Registered Nurse (RN) license in the state of California
• Bachelor’s Degree
• Master's Degree Preferred
• Minimum of 3 years' experience successfully managing people and leading teams.
• Minimum of 3 years' progressive leadership experience in MediCal/Medicare care management, must have model of care experience.
• Minimum of 7 years' combined experience managing projects, programs, complex change initiatives, and/or CMS and DHCS audits and regulatory
• compliance.
• Minimum of 7 years' experience in developing and executing strategic business plans and budgets with a track record of achieving results.

You Share Our Mission & Values:

• You are passionate about improving the healthcare experience and want to be part of the Altais mission.
• You are bold and curious- willing to take risks, try new things and be creative.
• You take pride in your work and are accountable for the quality of everything you do, holding yourself and others to a high standard.
• You are compassionate and are known as someone who demonstrates emotional intelligence, considers others when making decisions and always tries to do the right thing.
• You co-create, knowing that we can be better as a team than individuals. You work well with others, collaborating and valuing diversity of thought and perspective.
• You build trust with your colleagues and customers by demonstrating that you are someone who values honesty and transparency.

Altais values the contribution each Team Member brings to our organization. Final determination of a successful candidate’s starting pay will vary based on several factors, including, but not limited to education and experience within the job or the industry. The pay scale listed for this position is generally for candidates that meet the specified qualifications and requirements listed on this job description. Additional pay may be determined for those candidates that exceed these specified qualifications and requirements. We provide a competitive compensation package that recognizes your experience, credentials, and education alongside a robust benefits program to meet your needs.

Altais and its subsidiaries and affiliates are committed to protecting the privacy and security of the personal information you provide to us. Please refer to our ‘CPRA Privacy Notice for California Employees and Applicants’ to learn how we collect and process your personal information when you apply for a role with us.

Altais is a leading network of independent doctors focused on delivering personalized and high-quality health care in over 40 cities in California. Its network of more than 3,000 physicians, serving more than 355,000 HMO, ACO and PPO patients, is dedicated to improving care and reducing costs through innovative care management and care coordination programs, use of health care technology, and population health management strategies. For more than 30 years, Altais and its family of companies has proudly collaborated with leading hospitals and health plan providers to provide high quality care in California

Please note that Brown & Toland Physicians is a wholly owned subsidiary of Altais Clinical Services, a division of Altais. Other subsidiaries in the Altais family of companies include Altais Medical Group Riverside and Family Care Specialists Medical Group.