Care Transformation Coach

This is a fully remote position, open to applicants in New Jersey.

📋 Description

• Conducts data interpretation and analysis, performance evaluations, and readiness assessments to develop strategies, workflows, and tactics aimed at care transformation, ensuring alignment with performance indicators and the triple aim.

• Crafts high-quality action and/or project plans to propel value-based initiatives, including project development to assist strategic partners in identifying needs, implementation, monitoring, and refinement.

• Collaborates strategically with stakeholders to identify and prioritize goals that enhance care delivery, reduce costs, and improve quality.

• Chairs or participates in designated internal and external core teams and/or work streams, providing expertise to support transformation efforts for strategic partners.

• Leads the design and delivery of tailored Value-Based training sessions, including in-services and webinars.

• Conducts train-the-trainer sessions to extend transformation activities to a wider audience.

• Develops and facilitates the effective use of educational materials that consider health literacy for both internal and external partners (e.g., Value-Based programs, motivational interviewing, etc.) to foster learning collaboration and transform healthcare delivery with a focus on population health.

• Creates and implements customized tools to facilitate performance improvement.

• Analyzes and communicates data, project findings/results, and action plans to both internal and external stakeholders.

• Employs best practices to collaborate and enhance continuous improvement processes among Value-Based partners.

• Collaborates effectively with internal and external stakeholders to determine cultural change needs that can foster synergy among value-based programs.

• Engages with internal and external teams to develop and disseminate key performance indicators for monitoring adherence to best practices and achieving member outcomes.

• Maintains excellent relationships with various strategic partners, including healthcare providers, facilities, and other healthcare stakeholders throughout New Jersey.

• Engages with partners at all organizational levels, including physicians, nurses, and executives.

• Promotes a collaborative cross-departmental and cross-team environment, enhancing communication between transformation teams and other Horizon departments, such as health affairs, network management, sales, analytics, and government programs.

• Applies clinical best practices informed by research, national pilots, and Horizon experience for internal teams and external customers.

⛳️ Requirements

• High School Diploma/GED required.

• Bachelor's degree in Healthcare Management or a related field preferred, or relevant experience in lieu of a degree.

• Minimum of five (5) years of clinical experience in a healthcare setting, such as a health plan, hospital, or physician practice is required.

• RN, Licensed Clinical Social Worker, or Master of Public Health preferred.

• Direct experience with disease management, preventative management programs, or population health is required.

• Direct experience using data analysis to drive population health management and process improvement is necessary.

• Experience in continuous quality improvement, quality management, or rapid cycle improvement is required.

• Direct experience with behavioral coaching or motivational interviewing is preferred.

• Project management experience is preferred.

• Licensed RN or Social Worker preferred.

• An active NJ Driver's License is required.

• Basic understanding of health plan activities, including Utilization Management (UM), the CCM process, Disease Management, Population-Based Care Management, as well as basic claims processing, contracting, and enrollment is necessary.

• Knowledge of healthcare systems, practice and hospital-based care delivery, fundamentals of population health, value-based payment models, and medical documentation is required.

🏝️ Benefits

• Comprehensive health benefits (Medical/Dental/Vision).

• Retirement Plans.

• Generous PTO.

• Incentive Plans.

• Wellness Programs.

• Paid Volunteer Time Off.

• Tuition Reimbursement.