Cedars-Sinai RN Clinical Value Program Leader, GI - 8HR Days in Los Angeles, California
The Clinical Value Program Leader (CVPL) is responsible for supporting collaborative efforts focused on improving the value of health care in Gastroenterology services and related conditions. The CVPL works with Clinical Efficiency and Value and the Department of Medicine to identify opportunities to enhance clinical efficiency and appropriateness of care. As part of a multi-disciplinary team, the CVPL develops and implements interventions to achieve these improvements. The focus of these programs includes innovations to streamline inpatient care, safely reduce length of stay and cost of care, enhance transitions of care to the most appropriate post-acute setting, and reduce readmissions. Once these value-based programs are implemented, the CVPL assumes clinical operational responsibility for the program to ensure sustained focus within the department. The CVPL works closely with Clinical Efficiency and Value and the Department of Medicine to implement program refinements and/or initiation of new programs based upon outcomes or new payer requirements to ensure a sustainable model for coordinated value improvements. The ultimate goal is to meet the needs of third-party payers, to enhance Cedars-Sinai’s competitiveness to secure payer contracts, and to achieve internal clinical efficiencies to enhance operational performance — all while maintaining or improving the overall quality of care delivered.
The Clinical Value Program Leader is a proficient and experienced clinician who possesses an in-depth knowledge of patient care needs within Gastroenterology and consistently applies specialized knowledge and skills in the management of individuals or groups of patients and their families. The Clinical Value Program Leader understands relevant workflows in the delivery of care, including opportunities for improvement, and can apply that knowledge to develop and implement programs designed to achieve those improvements. Through collaboration with Clinical Efficiency and Value, the CVPL will develop greater proficiency in value-based principles, including payer requirements, risk-based contracts, drivers of utilization and cost, and the use of data to manage risk effectively. The CVPL will function as a liaison between Department activities and clinical efficiency efforts across the organization as led by Clinical Efficiency and Value.
-Working with Clinical Efficiency and Value and the Department of Medicine, identifies and validates opportunities to improve clinical efficiencies and appropriateness of care as well as reduce total cost of care within the assigned department(s).
-Working with Clinical Efficiency and Value and the Department of Medicine, develops, coordinates, and leads implementation of departmental programs aimed at improving value-based care. Supports department staff in understanding the rationale for evidence-based value-based care for the selected patient population. Provides regular updates on the status of the value-based programs to department leaders, clinicians, and operational staff.
-Identifies patients eligible for the value-based program, provides direct and indirect clinical care services to selected patients within the licensed scope of practice, including diagnosis and treatment, under the supervision of the designated physician lead for department value-based programs. Performs daily rounding and interfaces with clinical attendings, nursing staff, pharmacy staff, and case managers (or oversight of same). -Patient evaluation and care may be provided in the inpatient and/or ambulatory setting.
-Works with Inpatient Case Management, Inpatient Pharmacy, and Inpatient Nursing to support and coordinate hospital discharge by interfacing with patient and ancillary department staff in providing appropriate multi-disciplinary care. Connects patient to outpatient services provided through the value-based program such as Ambulatory Care Management. Follows and coordinates care of patients enrolled in value-based programs post-discharge to ensure optimal care during the prescribed post-hospitalization period. Provides education and assessment to support patient compliance with care guidelines. May manage post-discharge clinic workflow and facilitate care in the outpatient clinic.
-Functions as liaison with Clinical Efficiency and Value and the Department of Medicine to ensure that value-based metrics will be successfully met while maintaining alignment with departmental objectives.
-Interfaces with departmental clinical leaders, operational leaders. and champions to ensure that all clinical efficiency and value-based work is aligned with evidence based best practices and operational workflows and expectations.
-Implements plans to track outcomes for patients in value-based programs, including utilization, cost, efficiency, and appropriateness metrics, as well as clinical outcomes. Tracks outcomes and takes actions and/or makes recommendations based on information.
-Participates in Clinical Value Consortium to develop action plans to address barriers to value-based care and opportunities for interdepartmental collaboration and sharing of best practices across the Consortium. Spreads knowledge of value-based principles and addresses resistance within the assigned department(s) and to colleagues and peers in other departments.
-Maintains close coordination with Clinical Efficiency and Value and the Department of Medicine to review outcomes of the programs, address barriers to success, and develop plans for program modifications.
-Identifies new opportunities or target areas within the assigned department(s) as focus for future development efforts.
-Applies knowledge and practice of the clinical/technical skills necessary to the position consistent with the Nurse Practice Act, Title 22, The Joint Commission, the Plan for Provision of Nursing Care and the Plan for Provision of Care to Patients, and other regulatory requirements.
-May supervise staff in support of clinical and/or programmatic efforts.
Bachelor's of Science in Nursing (state accredited program) required
Master of Public Health, Hospital Administration, Health Delivery Science, or other applicable degree that enhances understanding of population health and value-based care. preferred
California State RN License
Require BLS unless a higher level of certification is required
3+ years of clinical experience in the relevant specialty area of the department required
1+ years of experience in developing, implementing, or overseeing clinical programs designed to make clinical quality, safety, or efficiency improvements preferred
Lifting, standing, walking
Working Title: RN Clinical Value Program Leader, GI - 8HR Days
Department: G.I. Consultations
Business Entity: Academic / Research
Job Category: ,Nursing,Nursing
Job Specialty: Advanced Practice (RN)
Position Type: Full-time
Shift Length: 8 hour shift
Shift Type: Day
Cedars-Sinai is an EEO employer. Cedars-Sinai does not unlawfully discriminate on the basis of the race, religion, color, national origin, citizenship, ancestry, physical or mental disability, legally protected medical condition (cancer-related or genetic characteristics or any genetic information), marital status, sex, gender, sexual orientation, gender identity, gender expression, pregnancy, age (40 or older), military and/or veteran status or any other basis protected by federal or state law.