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Parkland Health · 1 day ago

VP, Clinical Ops PCHP

Dallas, TX

Full-time

Hybrid

Lead/Staff, Director/Executive

5+ years exp

Parkland Health is a leading healthcare provider, and they are seeking a VP of Clinical Operations to provide strategic leadership for their clinical operations strategy. The role involves overseeing healthcare services, ensuring compliance with regulations, and managing financial performance while promoting a collaborative and inclusive work environment.

CommunitiesHealth CareHospitalMedicalNon ProfitWellness

H1B Sponsor Likely

Responsibilities

Responsible for developing the ongoing strategic, operational, and service design to achieve organizational goals

Works collaboratively with the Chief Medical Officer to develop and implement processes to effectively manage clinical policies to meet healthcare cost and quality targets

Develop integrated population health strategies in coordination with behavioral health

Identify and implement strategies and operational plans for optimal performance

Establish department goals, objectives, and standards of performance for assigned areas of responsibility

Develops and implements effective and efficient standards, protocols, processes, decision support systems, reporting benchmarks that support ongoing improvements of clinical operations functions and promotes quality cost-effective healthcare for PCHP members

Manages implementation of analytical studies that quantify the benefits of Health services programs to ensure that resources are appropriately allocated, operational controls exists, and efficiencies are maximized

Responsible for building, developing, and supporting UM program descriptions, medical policies development, as well as system implementation to comply with policies and build/maintain prior authorization tools to reduce employee and provider burden

Facilitates integration of care coordination, long-term care, acute and pharmacy services

Works with members and providers to develop an interdisciplinary team to assess, facilitate, plan and coordinate an integrated delivery of care across the continuum

Ensures effective inter-departmental collaboration and interaction between staff and other departments

Work collaboratively with Provider Relations, Health Equity, and Quality Management to build utilization trend reporting

Develop processes to maintain compliance with regulatory agencies and accrediting bodies. Ensures operations are carried out in compliance with these regulations

Works collaboratively with others to validate and sustain compliance with regulatory and accreditation standards

Conducts routine compliance audits identifying gaps and implementing remediation plans as necessary

Works collaboratively with leadership and/or PCHP Compliance to investigate and respond to matters of concern or alleged violations taking corrective action as necessary

Provides timely and accurate responses to requests for information from regulatory agencies and accrediting bodies

Periodically reviews processes and workflows for efficiency and to ensure compliance with contractual and regulatory requirements

Responsible for defining requirements and technical deliverables for complex regulatory reporting such as the HHSC 278 transactions and ACUR/TDI/OIG reports; monitoring submissions of data; monitoring pends/data rejections and correct submissions

Operationally responsible for the financial performance of assigned area(s)

Promote activities to achieve operational efficiency

Responsible for achieving business unit financial targets and requirements based on service level, state, compliance, and contractual agreements

Manage the approved budget through frequent and regular monitoring. Implement written action plans to address variances adjusting strategies as necessary to meet budgetary targets

Consider operational outcomes and financial implications when making recommendations to implement new programs or modify current programs

Manage staffing levels within established targets

Recruit and retain diverse talent with a variety of backgrounds, skills, experiences, and viewpoints that reflect the communities we serve

Promote and support a culturally welcoming, inclusive, collaborative, and highly engaged work environment where everyone feels empowered to bring their full, authentic selves to work

Accountable for orientation, ongoing education and training, and competency verification for all employees

Ensure Human Resource metrics (i.e., retention, vacancy, engagement) meet established targets. Utilize workforce metrics to monitor, identify, and respond to workforce trends

Timely completion of employee performance appraisals

Conduct regular meetings, inform team of changes in policy or procedure, and provide information regarding overall strategy and direction of the health plan

Mentor, coach, and support direct reports with building teamwork, professional development, and education to achieve optimal performance and develop talent

Ensure employee engagement survey participation rates and results meet established targets

Mandatory requirements are completed timely by employees

Required licensure, certification, and/or registry are current and in good standing for all employees

Employee performance is monitored and managed. Consult with the Office of Talent Management as appropriate regarding employee performance concerns and disciplinary action

Acts with the highest integrity and ethical standards while adhering to Parkland's Mission, Vision, and Values

Adheres to organizational policies, procedures, and guidelines

Completes assigned training, self-appraisal, and annual health requirements timely

Adheres to hybrid work schedule requirements

Attends required meetings and town halls

Recognizes and communicate ethical and legal concerns through the established channels of communication

Demonstrates accountability and responsibility by independently completing work, including projects and assignments on time, and providing timely responses to requests for information

Maintains confidentiality at all times

Performs other work as requested that is reasonably related to the employee's position, qualifications, and competencies

Identifies and analyzes the design of jobs, work processes, work flows, etc. for the area and implements appropriate changes to improve effectiveness, productivity, and efficiency that support the overall goals of PCHP

Stays abreast of the latest developments, advancements, and trends in the field by attending seminars/workshops, reading professional journals, actively participating in professional organizations, and/or maintaining certification or licensure. Integrates knowledge gained into current work practices

Maintains knowledge of applicable rules, regulations, policies, laws and guidelines that impact the area. Develops effective internal controls designed to promote adherence with applicable laws, accreditation agency requirements, and customer requirements. Seeks advice and guidance as needed to ensure proper understanding

Develops and monitors annual budgets that ensure the department has the necessary funds to carry out the goals and objectives that have been established for the department

Develops, implements, monitors, and revises annual goals and objectives for the department that support the missions and objectives of PCHP

Selects, trains, schedules, motivates, supervises, and evaluates employees making recommendations for disciplinary actions up to and including termination, to ensure maximum utilization of individual and group capabilities. Ensures that assigned employees receive opportunities to further their knowledge

Qualification

Clinical operations leadershipTexas Medicaid experienceRN licensure in TexasProject management certificationCoachingInfluencingData analysis skillsMicrosoft Office proficiencyStrategic thinkingCommunication skillsTime management skills

Required

Graduate of an accredited school of nursing required; BSN preferred

Master's degree in healthcare, business administration or related discipline preferred

Five (5) years of leadership experience in clinical operations required

Three (3) years of experience with Texas Medicaid, Medicaid and/or a Medicaid managed care organization required

STAR/STAR Kids, CHIP and Medicare/Medicare Advantage experience required

Experience building programs to address medically complex needs including LTSS (long-term service and support) and waiver services required

Current and unrestricted licensure as a RN in the State of Texas required

Excellent verbal and written communication skills including the ability to communicate effectively and professionally across disciplines and with a variety of constituents as well as the ability to articulate complex information in understandable terms

Must be able to successfully articulate the clinical strategies to a wide range of audiences including the CEO, the Board of Directors, clinicians, employees, partners, regulators, and other stakeholders

Demonstrated ability to coach and influence for results

Excellent people skills with the ability to establish and maintain effective working relationships with diverse groups across and beyond the organization

Strategic thinking and long-range planning skills with the ability to lead major organizational initiatives, accomplish results, and achieve measurable outcomes or goals

Must be able to work in challenging situations involving competing interests, and high level-interdisciplinary groups

Strong time management skills with the ability to manage multiple demands and respond to rapidly changing priorities

Solid clinician skills with in-depth knowledge of all aspects of care coordination, long-term care, acute care, and pharmacy services

Knowledge of Texas Medicaid (STAR/CHIP) program, National Committee for Quality Assurance (NCQA), the Uniformed Managed Care Contract, and the Uniform Managed Care Manual

Ability to analyze data for purposeful improvements in health outcomes

Proficient Microsoft Office and computer skills

Preferred

BSN preferred

Master's degree in healthcare, business administration or related discipline preferred

ACA/Marketplace experience preferred

Project management or Six Sigma certification preferred

Company

Parkland Health

Parkland Health first opened its doors in 1894 and is now one of the largest public hospital systems in the country.

Founded in 1894

Dallas, Texas, USA

10001+ employees

https://www.parklandhealth.org

H1B Sponsorship

Parkland Health has a track record of offering H1B sponsorships. Please note that this does not guarantee sponsorship for this specific role. Below presents additional info for your reference. (Data Powered by US Department of Labor)

Distribution of Different Job Fields Receiving Sponsorship

Represents job field similar to this job

Trends of Total Sponsorships

2025 (2)

2024 (2)

2022 (2)