Vice President Clinical Integration and Population Health
February 28, 2018
The Vice President Clinical Integration and Population Health guides the strategic direction, oversees program administration, and provides vision and leadership in aligning multiple disciplines of care. The position is responsible for reducing unnecessary clinical and operational variation through system-wide and implementing evidence based performance improvement efforts across key strategic areas. The position is responsible for utilization review, case management, transitional care management, quality and drives clinical excellence through collaboration with Service Line leaders and the medical staff to develop, deploy, and utilize evidence based care standards. The position is also responsible for ensuring compliance with governmental, DNV, CMS, and all other regulatory bodies.
The VP Clinical Integration and Population Health has responsibility and accountability for ensuring care coordination across the system. The position reports to the Senior Vice President and CNO.
Expectations/Measures of Success
â¢ Develops and continually tests and refines, appropriate interventions ensuring care at the right time, right place, and is high quality and cost effective.
Evaluate the infrastructure and resources of the current care delivery model for patient placement across the continuum.
Develops an innovative care delivery strategy to maximize shared cost and resources as well as improve the overall patient and provider experience across the continuum.
Ensures effective processes are in place to foster open lines of communications with leadership, physicians, and staff relating to clinical integration. Ensures information is communicated vertically and laterally to other departments as needed, and keeps leadership informed of any issues.
Develops a collaborative team based environment that drives clinically appropriate patient placement across the continuum.
Responsible for leading a team of physician advisors to develop and maintain a comprehensive, impactful Utilization Management program for each part of the continuum.
Revises plans, and/or policies and procedures when necessary in response to changes in the applicable laws.
Creates an empowering environment and continually builds a learning organization capable of being more nimble in a changing healthcare environment.
Effectively analyzes complex issues/problems (observation status, length of stay index, case mix index, etc) and leads/influences individuals and groups in developing and implementing successful resolution tactics.
Evaluates the landscape of clinical transformation (volume to value), quality measurement and reporting, risk based payment models, and develops tactics to redesign the clinical process to improve outcomes, lower costs, and utilize data effectively.
Drives change based on analytic data.
Develops and implements a quality improvement strategic plan to drive clinical outcomes, ensure correct patient placement, and reduce avoidable readmissions.
Develops and sustains an advanced inpatient, outpatient, ambulatory, and long-term care clinical documentation improvement program.
Provides ongoing education to physicians and other providers on medical record documentation specificity and communication to ensure accurate representation of the patient condition in the medical record.
Oversees process improvement to accelerate and drive an agenda of operational efficiency and clinical excellence.
Ensures data requirements are met for external reporting (Medicare, Annual Payment Update, DNV, commercial payers, and clinical certification programs).
Serves as a subject matter expert for Clinical Integration/Care Coordination.
Responsible for oversight of the recovery audit contractor (RAC) denials.
Educates and facilitates management and staff education regarding process improvement.
Responsible for leading departments such as Case Management, Utilization Review, Transitional Care Management, Quality, and Social Work.
â¢Works cooperatively with the Medical Staff and hospital personnel to ensure that the highest quality of health service is being provided to patients in the most appropriate level of care.
â¢ Maintains community affiliations to support and promote a positive image of Riverside HealthCare in the community.
â¢ Maintains professional affiliations and enhances professional growth and development to keep up with the latest trends in healthcare.
Participates with leaders from governing body, management, medical staff and clinical areas.
Develops and implements mechanisms for promoting the educational advancement and leadership development of patient care staff members.
â¢ Master's degree in Health Related Field and/or Nursing
â¢ Five years of leadership experience in a healthcare setting
â¢ BSN from an approved school of nursing
License or Certification Requirements:
â¢ Current Illinois RN licensure
Life is a remarkable journey. Health impacts every step â“ how we connect with others, how we express our potential, how we pursue our dreams. At Riverside our mission is to provide healthcare experiences that are just as remarkable. We do this for each and every person, regardless of their personal or economic circumstances. We offer our highest thinking, our kindest touch, and our strongest commitment to excellence.
Standards of Behavior
Following Riverside's commitment to professional standards of âœI RESPECTâ to Respond promptly, Exceed Expectations, Service excellence, Professionalism, Empathy, Confidentiality, and Teamwork.
â¢ Varying conditions regarding temperature control and potential exposure to hazardous materials.
â¢ Occasional exposure to clinical environments, which presents the normal hazards associated with healthcare environment.
â¢ This position will spend the majority of its time in office and meeting spaces, including long periods of sitting. Sufficient mobility and strength to ambulate about each facility and between facilities is necessary.