Managing Director, Clinical Operations

Evolent Health, Inc. Louisville, KY
Your Future Evolves Here

Evolent Health has a bold mission to change the health of the nation by changing the way health care is delivered. Our pursuit of this mission is the driving force that brings us to work each day. We believe in embracing new ideas, challenging ourselves and failing forward. We respect and celebrate individual talents and team wins. We have fun while working hard and Evolenteers often make a difference in everything from scrubs to jeans.

Are we growing? Absolutely--62% in year-over-year revenue growth through 2015. Are we recognized? Definitely. We're 12th on Forbes' list of America's Most Promising Companies for 2015, one of "Becker's 150 Great Places to Work in Healthcare" in 2016, and our CEO was number one on Glassdoor's 2015 Highest-Rated CEOs for Small and Medium Companies. If you're looking for a place where your work can be personally and professionally rewarding, don't just join a company with a mission. Join a mission with a company behind it.

Who You'll Be Working With:

Evolent Health is seeking a Managing Director of Clinical Operations to join the Clinical Operations team. The Managing Director will play a critical role in our growth as one of the senior leaders responsible for working with our health plan clients to realize targeted engagement, clinical and economic outcomes.

What You'll Be Doing:

* Oversees the development and ongoing operation of all health plan clinical operations and clinical program effectiveness.

* Responsible for directing and overseeing the overall client population health program performance and annual clinical initiative plan to drive expected/targeted client clinical, financial patient experience outcomes. Communicates results through appropriate channels.

* Hires, trains and directs Senior Director of Clinical Operations staff for individual Markets, as well as markt based quality teams.

* Responsible for communicating policies and procedures that integrate the work of all positions within the care management organization, and ensures that they are known and followed.

* Employs disciplined project management process to ensure the successful implementation of client care management programs

* Masters the company's population analytics, stratification and workflow technology platform and imparts this knowledge to the care management organization, ensuring that staff follows the policies and processes embedded therein.

* Drives the implementation of our clinical programs and quality management structure in collaboration with client clinical staff, community physicians, Evolent Health Chief Medical Officer, Pharmacy Director, and senior management team

* Responsible for interfacing and communicating with the multiple client regarding population health program performance, progress on implementing clinical initiatives and works with client to remove barriers to optimize performance.

* Partners with account management staff to insure our client organizations are establishing incentives, systems and processes to engage our client's employees in better accountability for their health.

* Serves as a change agent for and advisor to local health system staff, physicians, nurses and other clinical staff to assist them on their conversion to value-based care.

* Provide credible guidance to clients during strategy consulting phase of work related to population health infrastructure, existing programs and processes related to clinical operations, etc.

* Define innovative clinical models and design programs based on industry best practices and emerging approaches to integrated and transformational care delivery redesign.

* Develop physician-centric approaches to managing the continuum of care through primary care medical homes and specialist partnerships.

* Coordinate with all various internal and external functional areas (IT, network, communications, HPS, UM, )

* Involved in deployment of products/programs across commercial, Medicare Advantage and Medicaid programs and required to have deep knowledge of operational detail across all of these areas.

* Build and maintains strong client relationships with leadership at corporate, facility and department levels, building credibility and garnering crucial support for Evolent Health's process, methodologies and technologies

* Work with physician lead to convert network and clinical strategy into a clinical operational plan that will support the financial and quality targets for each population

* Will report to Vice President of Clinical Operations with accountability to market based leadership teams.

The Experience You Need (Required):

* 8-10 years of clinical staff management experience in a population management, clinical operations, managed care/insurance or hospital case management department setting

* Minimum of 4 years of operational management experience in a clinical setting

Finishing Touches (Preferred):

* Sophisticated knowledge of clinical operations in managed care, including quality management, outcomes, provider network, claims, financial management, care management policies, disease state and population management, members' rights and responsibilities, and ability to quickly assess client practices.

* Current Registered Nurse license

* Experience in consulting or services organizations with a proven ability to manage client relationships and achieve change within another organization.

* Desire for and capability to drive toward and achieve a high standard of quality and results

* Working knowledge of clinical quality metrics such as HEDIS, NCQA or National Quality Forum type metrics.

* Entrepreneurial mindset geared toward the creation, execution and continuous improvement of a new care management model from the ground up.

* Ability to work in a fast paced, team environment with sensitivity toward client needs and critical deadlines.

* Intellectual curiosity and an ability to view old problems with a fresh perspective.

* Ability to understand the workflow of the multiple components of the company and client, and to assist in the creation and implementation of integrated policies, procedures, work plans and creative solutions.

* Experience in project management and process improvement.

* Experience in data analytics (preferably population analytics), and use thereof to target opportunities.

* Ability to attract, manage and develop staff of superlative quality

* Excellent written, computer, and oral communication skills.

Evolent Health is an Equal Opportunity/Affirmative Action Employer