Vice President, Care Coordination

VP of Care Coordination

As the VP of Care Coordination, you will oversee the complete function of patient intake, resupply, insurance verification, prior authorization, medical necessity documentation procurement, recertification for payors, order quality assurance, and customer service with patients.

The function is a centralized shared service function serving all Respire regions. Your daily management role will involve operationally leading two Directors (New Patient Intake & Existing Patient Resupply), setting strategy, reinforcing policies, tracking key metrics, operationalizing changes through your leadership teams in response to metrics, addressing customer service escalations, and communicating effectively across peer departments.

In this role, you will report to the Chief Executive Officer or Chief Operating Officer and manage 2 Directors and have indirect supervision over 5 Managers and 64 individual contributors.

Responsibilities and Duties :

• Develop and monitor key performance metrics, assign tasks based on team members' strengths, and perform quality checks to identify training needs.
• Establish strategies and operational plans for providing a top-tier customer service experience and ensuring a timely and efficient intake process for patients.
• Establish and reinforce policies, especially around compliance and reimbursement.
• Hold Directors and downstream Managers accountable for proper engagement and performance management of their teams.
• Intervene on order processing variances to ensure that the performance commitments to our patients are being upheld.
• Manage downstream leaders to the budget and / or financial performance realities in terms of expense management and staffing.
• Drive professional growth and reward high performers, ensuring a positive and effective work environment.
• Ensure the team develops a trusted advisor relationship with customers, including answering calls, completing customer onboarding / training, and troubleshooting / managing escalations as needed.
• Develop and maintain key metrics and goals to monitor personal and team performance and effectiveness.
• Identify the strengths and skills of team members to assign tasks effectively.
• Ensure that deadlines are realistic and communicated clearly.
• Perform quality checks on individual work performance, identify training needs, and provide coaching.
• Ensure management team members are doing a great job leading their teams, communicating, addressing issues, and achieving business milestones.
• Oversee engagement of patients and referral sources in order status, ensuring timely follow-up as needed.
• Monitor departmental KPIs for normal operations and project deliveries.
• Maintain an approachable demeanor and encourage team members to share their concerns and feedback at any time.
• Support team members’ professional growth by providing opportunities for training, mentoring, and career advancement.

Key metrics that Care Coordination will be expected to manage :

• Patient Net Promoter Score
• New Order Follow-up & Completion
• Order Confirmation Time
• Untouched Faxes Per Day
• Average Call Hold Time
• Average Abandon Rate
• Duration to Return Voicemail
• Unreturned Phone Calls Per Day
• Call Abandon Rate
• Resupply Order Completion
• Percentage of Orders Processed Without PARs and / or CMNs
• Overtime Rate

Qualifications :

• 7+ years of health experience required; Durable Medical Equipment Preferred.
• Prior experience in managing intake processes and conducting insurance verifications is required.
• Strong work ethic and builder of work ethic culture on their team.
• Strong leadership skills to inspire, motivate, and guide team members toward a common goal of delivering exceptional customer experiences.
• Ability to lead geographically dispersed teams with remote workers.
• Strong accountability management style to deliver to KPI expectations and budgetary commitments.
• Data-oriented using scorecards of metrics and leading operational changes based upon the data.
• Demonstrated ability to be a leader-of-business unit.
• Detail-oriented, organized, with excellent written and verbal communication skills.
• Exceptional communicator with a proven track record of effective change management capabilities.
• Calm under pressure, can excel and thrive in a high-volume, continuously changing, fast-paced environment.
• Analytical skills to interpret customer data and feedback and KPIs, identify patterns, and extract insights that inform decision-making.
• Must be able to develop and document standard operating procedures and provide training internally and externally.
• Must have strong time management skills, ability to multitask and stay organized.

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