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The Director of Care Management is responsible for the development of the quality and care management infrastructure along with programs to promote ongoing improvement in the care delivery model. The infrastructure and programs will drive performance on clinical quality metrics and improve the health of the population through preventive health promotion, disease management, case management and care coordination activities. The incumbent will act as a technical and content resource for all clinical quality improvement activities of the organization and will serve as a consultant to other entities and partners. The Director of Care Management plays a critical role in Blaze’s ability to delivery on the value proposition of highest quality care delivered with exceptional service at the lowest possible cost.
Achieve market distinction in clinical quality with goal of top performance amongst peer organizations
Establish and meet medical management standards and corporate objectives for preventive care, acute care, chronic disease management, resource utilization and clinical quality
Implement programs to optimize the utilization of clinical services, including but not limited to care coordination and case management
Identify and reduce unwanted clinical practice variation
Analyze and report key metrics to ensure performance on financial, service, and quality metrics
Effectively collaborate and partner with leaders and other key stakeholders on quality and care management programs to improve the health of customers.
Effectively collaborate and partner with medical informatics leadership to maximally leverage the use of the electronic health record in care management and quality improvement programs. Develop, benchmark, and communicate appropriate metrics to measure success and sustainability of improvement efforts
Enthusiastically embrace and commit to a customer-oriented focus in process improvements and determine key drivers to provide an exceptional customer experience
Communicate and collaborate with all levels of the organization to promote a continuous improvement environment
Proactively communicate with leadership on improvement initiatives and barriers to success
Identify, leverage, and share best practices across the organization
Provide leadership and oversight of staff. Set direction and objectives, as well as provide feedback for those individuals focused on continuous process improvement
Prepare, monitor and meet departmental human resources and operating budgets
Perform other duties as assigned.
Thought Leadership (Analysis, Strategic Thinking, Financial Acumen)
Use Insightful Judgment
Seek Innovative Solutions
Apply Financial Action
Results Leadership (Focus on Customers, Managing Execution, Results Orientation)
Focus on Customers
See Challenges as Opportunities
People Leadership (Engage and Inspire, Talent Enhancement)
Engage and Inspire
Personal Leadership (Adaptability)
Recognizes and complies with legal regulatory, accrediting and procedural requirements related to area of
Understands and follows principles and standards as outlined in Blaze Health’s Corporate Code of Conduct.
Protects customer and team member privacy and only accesses customer and/or team member related information as needed to perform job
Reports violations or areas of concern to supervisor or Corporate Compliance Officer via established methods of
Master’s degree in health care related field
Seven (7) years of progressive leadership experience in quality and care management
Experience in multi-specialty clinic environment
Knowledge, Skills and Abilities
Demonstrated experience and/or training in clinical process improvement, quality improvement methodology, evidence-based medicine, and an understanding of regional and national metrics related to clinical quality excellence and performance reporting
Demonstrated knowledge of and success in implementing quality improvement and population health interventions using systems thinking, formal process improvement methodologies, and proven quality improvement strategies
Demonstrated strong leadership, communication and team building skills
Project management and change management experience, preferably in a leadership capacity.
Internal Number: 494292
About Blaze Health
A leading provider and insurer, teaming up to transform the world of healthcare.
Blaze Health is a collaboration between North Memorial Health and Blue Cross and Blue Shield of Minnesota that is committed to providing better healthcare. Blaze Health is the driving force behind North Memorial Health primary care clinics, specialty care clinics and hospice. Our mission is to offer a better way to navigate healthcare and improve the customer experience.