Collective Health gives companies a smarter alternative to traditional health insurance. Through a cloud-based, integrated health benefits platform, the company enables self-insured employers to get more out of their healthcare investment while taking better care of their people. Our clinical programs engage our members and their families in their times of need, establish trust and influence their decisions and help them through every stage of care. Blending our compassionate and highly skilled member advocates, clinical experts and intelligent technologies we deliver single point-of-contact clinical programs that consistently achieve 98% customer satisfaction ratings and achieve employer cost savings. Collective Health was just ranked as one of the top 100 medium-sized places to work by Fortune.
As Director, Clinical Services you will have P&L responsibility for the delivery and execution of our clinical program offerings, ensuring that our clinical staff and technology have the right focus across our delivery model to achieve performance guarantees and other client and member commitments. You will also develop and then provide clinical oversight and guidance to other cross-functional Collective Health teams, ensuring that we are operating according to established clinical practices and understanding.
You will partner closely with our Senior Medical Director, Product Leadership, Analytics Leadership and Operational Leadership to design, implement and deliver client and member expected outcomes. You will lead our growing Collective Care team, made up of Pharmacists, Social Workers, Program Managers and Care Coordinators and have accountability to influence, engage and motivate your team to drive the right behaviors and process execution to achieve client, member and business goals.
- Accountable for the P&L and day-to-day business operations and performance of the Collective Health clinical offerings
- Accountable for the performance and strategic expansion of the Collective Care team
- Serve as the voice of Collective Health clinical operations both internally and externally and work closely with 3rd party partners on program alignment
- Develop processes to provide and then deliver clinical oversight and guidance to our Member Advocate and Member Claims Associate teams
- Regularly perform and review internal audit results in addition to client feedback and program performance data to develop and execute on action plans to iterate and improve programs
- Oversee client clinical audits
- Develop effective coaching relationships and mechanisms with your team to deliver superior management of member cases and to foster internal team satisfaction
- Establish two-way relationships with your Sales, Client Success counterparts to thoroughly understand market clinical offering demand in order to adapt and iterate clinical offerings to client and member needs
- Establish two-way relationships with your Product and Analytics counterparts to drive a technology and data-first approach in our clinical offerings
- Develop and review contract and SLA language with our Legal and Sales Operations teams to ensure compliance and build processes for tracking and monitoring program performance
- Active clinical license (MD, RN, LCSW) recommended
- Clinical domain expertise with a broad knowledge of industry business clinical operations
- Demonstrated success in clinical solution design with extensive experience in process design and technical integrations
- Demonstrated experience with complex data analysis
- Demonstrated experience with electronic data interface and case management systems
- Project Management, presentation, and strong planning and decision-making skills
- Excellent communications, leadership and interpersonal skills
- Solid business acumen, analytical and inquisitive
- Strong emotional intelligence and ability to influence
- Ability to effectively collaborate and execute in a highly matrixed environment
- Self-starter with a “roll up your sleeves” mindset and desire to add value
- Comfortable operating with change and uncertainty
- Team player capable of working effectively with individuals throughout the organization
We are an equal opportunity employer and value diversity at our company. We do not discriminate on the basis of race, religion, color, national origin, gender, sexual orientation, age, marital status, veteran status, or disability status.