Primary City/State:

Arizona, Arizona

Department Name:

ALTCS CM

Work Shift:

Day

Job Category:

Clinical Care

The future is full of possibilities. At Banner Plans & Networks, we’re changing the industry to reduce healthcare costs while keeping members in optimal health. If you’re ready to change lives, we want to hear from you.

Banner Plans & Networks (BPN) is a nationally recognized healthcare leader that integrates Medicare and private health plans. Our main goal is to reduce healthcare costs while keeping our members in optimal health. BPN is known for its innovative, collaborative, and team-oriented approach to healthcare. We offer diverse career opportunities, from entry-level to leadership positions, and extend our innovation to employment settings by including remote and hybrid opportunities.

Your pay and benefits are important components of your journey at Banner Health. This opportunity includes the option to participate in a variety of health, financial, and security benefits. In addition, this position may be eligible for our Management Incentive Program as part of your Total Rewards package.

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.

POSTION SUMMARY

This position is responsible for leading the management of the portfolio of ALTCS Case Management improvement across Banner including case management strategic initiatives that positions the organization to be a leader in providing customer obsessed, high quality reliable case management care, and making it easy for providers to care for our customers. This position directs the case management consensus infrastructure, methodologies and coordination of resources in partnership with case management and administrative leaders and physicians across Banner.

CORE FUNCTIONS

1. Directs system-level case management improvement, supporting a culture of change, ensuring evidence-based standard outcomes and achievement of case management improvement goals and effective integration into operations. Directs successful implementations of case management activities across a diverse set of operating entities; ensuring differences of scales and scope across the organization.

2. Develops and implements strategies and tactics to optimize case management improvement structures, methods and resources that are in alignment with organization strategies and direction.

3. Oversees the functions and resources that support the case management consensus groups ensuring that regulatory, compliance and accrediting body requirements are met and improvement methodologies, policies and procedures are followed.

4. Builds, supports, and maintains effective relationships with internal and external stakeholders and organizations. Represents Banner in an internal/external facing leadership role. Coordinates activities, reviews work, exchanges information, and/or resolves problems in a timely and professional manner.

5. Directs and participates in the development, implementation, and consistent application of effective organizational policies, procedures, and practices. Develops and supports internal controls to ensure that assets are safeguarded, policies and operating procedures are followed, necessary controls are effective and efficient, and compliance with current laws and regulations is achieved.

6. Develops and oversees the department budget to meet corporate goals and objectives. Meets annual budgetary goals. Translates organizational plans, goals, and initiatives into assumptions for annual operating and/or capital budgets. Negotiates contracts with external vendors for products and/or services and monitors/evaluates quality and/or performance. Manages and reports expenditures.

7. Communicates the department vision, translating it into actionable projects and activities. Maximizes management staff’s contributions and assures timely decision-making reflecting the mission, vision, and values of the system.

8. This position has direct leadership accountability for all aspects of system-wide case management improvement teams/work groups and consensus groups. This position requires the skill to negotiate and influence. Customers of this position are both internal and external including physicians, case management experts, leadership and the community.

Performs all functions according to established policies, procedures, regulatory and accreditation requirements, as well as applicable professional standards. Provides all customers of Banner Health with an excellent service experience by consistently demonstrating our core and leader behaviors each and every day.

MINIMUM QUALIFICATIONS

Requires a Bachelor’s degree level of knowledge in management, preferably health care administration, coupled with five or more years of increasingly responsible administrative leadership experience in a Managed Long Term Service and Supports (MLTSS) environment, preferably within the state of Arizona.

Proven track record of partnering with regulators, long term care organizations and contracted providers to achieve desired organizational outcomes. Proven experience in leading efficient, and responsible health care operations.

Strong financial and business acumen, including a keen understanding of operational and financial measures that define success,
Knowledge of emerging trends in quality and patient safety. Skilled in coaching and developing direct reports and/or other employees that results in enhanced performance outcomes; setting in pursuing aggressive priorities and goals that demonstrate a strong commitment to overall organizational success; effectively allocating resources in order to accomplish goals and objectives; quickly assessing and assimilating facility and industry financial dynamics in order to act quickly and appropriately to changing environmental factors; negotiating win-win scenarios with outside vendors/partners while representing the organization in the best possible light; developing collaborative and positive relationships with contracted providers, regulators, employees, the community, and/or other applicable parties; measuring and managing work outputs. Excellent human relations, organizational and communication skills are essential.

Sound knowledge of ALTCS Case management as typically obtained through a minimum of five years of progressively responsible behavioral healthcare management in an ALTCS setting.

Must possess a strong knowledge and understanding of healthcare trends and financial management of healthcare operations. Knowledge of the requirements of the various regulatory and accrediting agencies as applicable.

Requires strong written and oral communication skills. Must demonstrate strong decision making, critical thinking and group facilitation skills along with the ability to lead change and to rapidly prioritize needs. Must possess ability to develop strong relationships with suppliers and customers. Analytical and critical thinking skills are required to integrate and interpret data from diverse sources. Ability to integrate information to establish business priorities, decisions, and budgets. Must be highly computer literate.

PREFERRED QUALIFICATIONS

Additional related education and/or experience preferred.

EEO Statement:

EEO/Female/Minority/Disability/Veterans

Our organization supports a drug-free work environment.

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