Director, Clinical Performance at Bright Health
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Our Mission is to Make Healthcare Right. Together. Built upon the belief that by connecting and aligning the best local resources in healthcare delivery with the financing of care, we can deliver a superior consumer experience, lower costs, and optimized clinical outcomes.
What drives our mission? The company values we live and breathe every day. We keep it simple: Be Brave. Be Brilliant. Be Accountable. Be Inclusive. Be Collaborative.
If you share our passion for changing healthcare so all people can live healthy, brighter lives – apply to join our team.
SCOPE OF ROLE
The DCE Clinical Director is responsible for the implementation, oversight, and monitoring of Neuehealth’s DCE clinical programs. This role implements an effective clinical oversight and monitoring methodology that includes performance improvement to meet established performance goals specifically for the Direct Contracting Entities. The role has responsibility for management of the clinical assurance teams that will drive the clinical oversight and monitoring requirements for each DCE Care Partners.
- Develop partnerships with key stakeholders in the Healthcare ecosystem for implementation of the DCE Clinical Standards and Oversight the clinical performance of DCE Care Partners.
- Responsible for the collaboration and development of the DCE Care Partners Quality Improvement strategies based on key planned activities for the performance year.
- Ability to develop documented processes to support implementation of the DCE clinical programs; to include value stream mapping and standard operating procedures where needed.
- Ability to collaborate with analytics to support the development and maintenance of the data governance structure for DCE clinical outcome measures
- Works closely with Compliance to ensure appropriate operational responses to regulatory changes and ensures the clinical assurance teams disseminates and implements changes.
- Manage a team of clinical assurance nurses and clinical consultants (analysts) across geographies.
- Work closely with the Implementation Manager and/or Program Managers to inform on clinical program initiatives
- Adheres to the Policies and Procedures set forth by Neuehealth and performs all additional duties as assigned
EDUCATION, TRAINING, AND PROFESSIONAL EXPERIENCE
- Master’s degree in nursing, Business, or other related Healthcare field
- Certified Case Management preferred
- Minimum 5 years’ experience in a supervisory capacity
- Minimum 10 years’ experience in population health management
- Project Management experience preferred
LICENSURES AND CERTIFICATIONS
- Active and unrestricted license as a Registered Nurse (RN)
- High Attention to detail and Strong analytical skills
- High level of critical thinking and problem-solving skills
- Strong work ethic and overall positive attitude
- Effective communication skills including verbal and written
- Ability to manage time effectively, understand directions, and work independently in a fast-paced environment
- Demonstrated flexibility, organization, and self-motivation
- Highly adaptable to change
The majority of work responsibilities are performed in an open office setting, carrying out detailed work sitting at a desk/table and working on the computer. Some travel may be required. Ability to lift at least 50 pounds.
We understand patient pain points, eliminating complexity while increasing transparency, for greater access and easier navigation.
We integrate and align individual incentives at all levels, from financing to optimization to delivery of care.