Associate Director, Central Specialty Operations

We’re unique.  You should be, too.

We’re changing lives every day.  For both our patients and our team members. Are you innovative and entrepreneurial minded? Is your work ethic and ambition off the charts?  Do you inspire others with your kindness and joy?

We’re different than most primary care providers. We’re rapidly expanding and we need great people to join our team.

The Associate Director, Central Specialty Operations owns the operations of ChenMed’s centrally and virtually delivered specialty services, including clinical appropriateness reviews, physician-to-physician curbside consultations, telehealth programs, clinical pathways, and other related opportunities that arise over time. Reporting to the VP, Specialty Strategy & Operations, this position builds and runs the operating model for these services and works as a collaborative peer with physicians and clinical leaders to make sure patients receive the right specialty care, at the right time, within our Medicare Advantage capitated model. Additionally, this role is expected to bring advanced systems thinking and AI-native workflow design, and will be expected to drive adoption and innovation using technology. The role starts as a hands-on leader and is expected to grow in team and scope as the central services mature.

ESSENTIAL JOB DUTIES/RESPONSIBILITIES:

• Clinical appropriateness reviews: Owns end-to-end operations of the central review process in which specialists review PCP referral requests for appropriateness and advise on whether a referral is necessary

• Manages intake, reviewer capacity and scheduling, turnaround times, and decision documentation

• Partners with specialist reviewers and PCPs to establish and calibrate review criteria and share feedback in a collaborative, supportive manner

• Monitors review quality, consistency, outcomes, and labor cost, and directs review effort to where it adds the most value

• Curbside consultations: Operates curbside consultation programs that give PCPs fast, informal access to specialist guidance

• Sets specialist participation expectations, response-time standards, and escalation paths

• Tracks utilization, responsiveness, and the downstream care avoided or redirected

• Telehealth and virtual care: Designs, pilots, and scales telehealth projects that extend specialist access to patients and care teams

• Defines pilot scope, workflows, and success measures, then evaluates early results

• Recommends whether and how to scale, and leads the operational rollout

• Clinical pathways: Operationalizes clinical pathways in partnership with medical leadership and specialists

• Translates clinical guidance into practical workflows, tools, and training for the field

• Tracks adoption and impact and drives continuous improvement

• Technology & Innovation:  Build new, and transform existing, workflows using AI

• Operating model and performance: Defines the operating model, key metrics, and reporting for all central specialty services

• Works with the performance and analytics team to build dashboards and use them in regular operating reviews

• Diagnoses root causes, prioritizes improvements, and drives results across cost, quality, speed, and experience

• Cross-functional partnership: Partners with National Specialty Operations, Network, medical leadership, and Performance & Automation so central services reinforce field operations

• Engages physicians and clinical leaders as a peer to align on protocols, resolve friction, and drive adoption

• Team building: Builds and develops the team over time, beginning as a hands-on leader and adding leaders and specialists as volume and scope grow

• Performs other duties as assigned or modified at manager’s discretion.

KNOWLEDGE, SKILLS AND ABILITIES:

• Strong analytical and problem-solving skills, with a systems-thinking mindset and the ability to map workflows and find root causes
• Working knowledge of value-based care and Medicare Advantage capitated models
• Ability to build credibility and collaborate as a peer with physicians, clinical leaders, and senior executives
• Highly attentive to detail with strong focus on accuracy and quality
• Existing knowledge of AI required, along with a strong desire to continue learning and self-teaching
• Familiarity with referral management, utilization or care management, and clinical operations environments
• Comfortable working with data, including dashboards and performance metrics; proficient in Excel, Word, PowerPoint, Outlook, and other systems required for the position
• Ability to lead through ambiguity, build new programs, and move quickly in a fast-paced, growth-oriented environment
• Ability and willingness to travel locally, regionally and/or nationally up to10% of the time; flexible to work evening, weekends and/or holidays as needed
• Spoken and written fluency in English
• This job requires use and exercise of independent judgment

 

EDUCATION AND EXPERIENCE CRITERIA:

• BA/BS degree in healthcare administration, nursing, public health, business, or similar discipline OR additional experience above the minimum may be considered in lieu of the required education on a year-for-year basis

• Clinical background (e.g., RN, NP, PA, PharmD) or equivalent clinical background preferred; master’s degree preferred

• A minimum of eight (8) years’ work experience in healthcare operations, including at least three (3) years leading people or programs, is required in areas such as care management, utilization or referral management, clinical operations, or virtual care

• Experience with value-based care or Medicare Advantage preferred

• Experience launching new programs or services, including in a startup or high-growth healthcare company, preferred

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PAY RANGE:

$118,062 - $168,658 Salary

The posted pay range represents the base hourly rate or base annual full-time salary for this position. Final compensation will depend on a variety of factors including but not limited to experience, education, geographic location, and other relevant factors. This position may also be eligible for a bonuses or commissions.

EMPLOYEE BENEFITS

https://chenmed.makeityoursource.com/helpful-documents

We’re ChenMed and we’re transforming healthcare for seniors and changing America’s healthcare for the better.  Family-owned and physician-led, our unique approach allows us to improve the health and well-being of the populations we serve. We’re growing rapidly as we seek to rescue more and more seniors from inadequate health care. 

ChenMed is changing lives for the people we serve and the people we hire.  With great compensation, comprehensive benefits, career development and advancement opportunities and so much more, our employees enjoy great work-life balance and opportunities to grow.  Join our team who make a difference in people’s lives every single day.

Current employees, if you want to apply to our internal career site, please click HERE

Current Contingent Worker please see job aid HERE to apply

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