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The Population Health Management team leads coordination and care management for Banner Insurance Division members. This includes complex care, readmission focused, disease management and health navigation teams. All ensure customer obsessed care and patient centered goals are achieved.
Your pay and benefits are important components of your journey at Banner Health. This opportunity is also eligible for our Management Incentive Program, as part of your Total Rewards package. Banner Health offers a variety of benefits to help you and your family. We provide health and financial security options so you can focus on being the best at what you do and enjoying your life.
Banner Health Network (BHN) is an accountable care organization that joins Arizona's largest health care provider, Banner Health, and an extensive network of primary care and specialty physicians to provide the most comprehensive healthcare solutions for Maricopa County and parts of Pinal County. Through BHN, known nationally as an innovative leader in new health care models, insurance plans and physicians are coming together to work collaboratively to keep members in optimal health, while reducing costs.
This position is responsible for developing and implementing workflows, processes and strategies to facilitate the coordination of the company's Health Management needs. Provides leadership, direction and support for the efficient and smooth coordination of patients, member and provider needs with needed resources throughout the organization. Achieves quality outcomes, reduces costs, and shapes and interprets the standards required to ensure a high degree of patient, physician and employee and member satisfaction.
1. Plans, directs and monitors the system inbound and outbound central support center program and supporting processes. Provides advice, counsel, feedback and coordination to promote a collegiality between staff, physicians and the company leadership teams.
2. Ensures the strategic development of operations surrounding health management services to support the organization's strategic plan. Designs and implements processes to ensure safe inbound and outbound transactions according to regulatory and standards of safety and designated workflows.
3. Provides leadership in the development, implementation and evaluation of new and re-engineered programs and services to address the changes in the Health Management environment. Ensures support of system strategic direction through the development, improvement and delivery of coordinated and integrated system services. Provides direction for multidisciplinary process of patient flow by implementing improvement activities, including the establishment of performance measures to attain optimal clinical, operational, financial and satisfaction outcomes. Directs the collection, analysis and presentation of data on patient requests patterns and other program outcomes.
4. Directs personnel actions including recruiting, new hire actions, interviewing and selection of new staff, salary determinations, training, and personnel evaluations. Participates in the development of case management goals and objectives in accordance with company standards.
5. Manages the financial and capital resources for inbound and outbound health management operation services by monitoring operating revenue and expenses, establishing and maintaining cost control programs and developing and implementing new or revised programs and/or services.
6. Develops and oversees the department budget in conjunction with corporate goals and objectives. Accountable for meeting annual budgetary goals.
7. Oversees coordination and operations of highly matrixed programs and processes that support health management strategy. Maintains optimal communication between stakeholders, staff and the associated programs.
8. Responsibility for Health Management Operational Services. Internal customers: BHN, Health Management Team, patients/members, and other health care members for the purpose of integrating services, improving patient care, ensuring effective communication systems and facilitating decision making in clinical practice and business related issues. External customers: Patients and families regarding patient care issues; physicians regarding patient care and program development; agency vendors and contracted services; staff from other health care agencies/providers and community/professional organizations as needed; and Joint Commission, state, federal and community agencies regarding compliance with laws and regulations.
Requires knowledge as typically obtained through completion of a Bachelor's Degree in Health Administration, Business or Nursing or the equivalent. Masters strongly preferred. Minimum of five to seven years of health care and related industry sales experience, or the equivalent required. Prior demonstrated experience to lead and manage others is required. Excellent interpersonal, organizational, presentation, communication skills and computer literacy also required. Must have considerable experience with patient population in the area of responsibility and at least 2 years of management experience. Must possess demonstrated flexibility in responding to the needs of multiple constituencies with a service-oriented philosophy. Must also possess demonstrated skill in problem analysis, project management, contract negotiation, conflict resolution and oral/written presentation. Requires strong working knowledge of patient placement and regulatory standards.
Master's degree in nursing or business is preferred.
Additional related education and/or experience preferred.
DATE APPROVED 08/14/2016
Internal Number: R3983
About Banner Health
You want to change the health care industry – one life at a time. You belong here. You’re excited to be part of the dramatic changes happening in the health care field. In fact, you thrive on change. But you also understand that excellent, compassionate patient care is the true measure of the success of these changes. You belong at Banner Health. Our award-winning, comprehensive health system includes 23 hospitals in seven western states, primary care health centers, research centers, labs, a network of physician practices and much more. Throughout our system, skilled, compassionate professionals use the latest technology to change the way care is provided. If you’re looking to be a key contributor to a forward-looking organization, you’ll experience a wide variety of professional advantages: •Our vision for changing the future of health care gives you the opportunity to leverage your abilities to achieve something historic. •Our expansive system offers you an unmatched variety of clinical settings – from large urban trauma center to small rural hospital, ambulatory to home health. Our system also includes hospitals specializing in cancer, heart health and pediatrics. •Our many loc...ations also translate into a broad selection of exciting and rewarding lifestyle options – from the big city to the wide-open spaces. •Our commitment to healthcare innovation means you always have the latest technologies at your fingertips to help you provide the finest care possible. •The size, success and growth of our system provide you with the stability and options to pursue your desired career path. •Our competitive compensation and comprehensive benefits offer you options to complement your unique needs.