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The President of this organization is responsible for changing the way payors and providers engage and operate together. This role is responsible for the planning, executing, and managing the enterprise's advanced network strategy and practice transformation objectives. This includes the development, implementation process and ongoing operations for the enterprise's Accountable Care Organizations (ACO) model, Management Services Organizations (MSO) model and advanced provider partnerships. This role is responsible for driving cross-organization relationships and coordinating the collaboration among hospitals, medical groups and stakeholders to achieve integration and cost saving effectiveness as well as ensuring quality of services by designing and monitoring leading indicators and is accountable for establishing provider best practices and programs.
Directly manage the CHS organization's P&L performance.
Develop and lead the creation of the enterprise's advanced network and provider transformation strategy; challenges the status quo and sets aggressive multi-year goals; closely coordinates with the local plan leadership and enterprise network performance organization.
Leads business development efforts to create and grow new ACO, MSO and advanced partner relationships.
Develops strategies to leverage the ACO, MSO and advances partner relationships to improve health plan performance.
Provides leadership, direction and support in the management of the enterprise's ACO, MSO and advances provider partners daily operations, including care management, credentialing, network development, physician contracting, member services payer relations, finance and clinical informatics.
Leads the administrative effort to drive and measure improvements in quality, total cost of care an improved member experience.
In partnership with internal stakeholders, develops and executes on overall approach for ACO contract negotiation and renewal strategy.
Leads large-scale organizational and transformational change both internally and with external partners including major initiatives in provider practice effectiveness, technology, physician workforce management areas and culture.
Manages and develops relationships with healthcare delivery partners.
Leads organizational development activities that develop and foster strong working relationships among the members of the management team. Builds and promotes the culture of the plan to be consistent with the values established by the enterprise.
Establishes formal and informal mechanisms to promote and maintain credibility, competence, and positive corporate image by exhibiting strong communication to the corporate office, providers, members and committees.
Communicates network strategies and operational results to senior level executives.
Performs other related duties as assigned by management.
Required A Bachelor's Degree in Business administration, finance, healthcare administration, operations or a related field.
Preferred A Master's Degree in a related field Business administration, finance, healthcare administration or a related field.
Required 10 years of experience in Progressive related business management experience in high-impact executive roles with multi-site profit and loss accountability. Related experience in ACO or MSO strongly preferred.
Required 7 years of experience in ACO, MSO and/or Managed Care.
Required Other Experience with Medicaid and/or Medicare managed care programs.
Required Other Experience engaging healthcare delivery constituents and building relationships.
Required Other Experience fostering relationships with government and regulatory entities, national trade bodies, CMS and other industry groups.
Advanced Demonstrated leadership skills
Advanced Demonstrated ability to deal with confidential information
Advanced Demonstrated written communication skills
Advanced Demonstrated interpersonal/verbal communication skills
Advanced Demonstrated organizational skills
Advanced Ability to work in a fast paced environment with changing priorities
Advanced Demonstrated problem solving skills
Advanced Other Leads with purpose; has personal direction and is able to handle a broad workload and prioritize tactics. Demonstrates strong commitment to the success of the organization and is willing to make personal sacrifices to contribute to that success. Maintains sound integrity and is described by others as honest; consistently takes responsibility for his/her actions.
Advanced Other Handles criticism effectively; does not act threatened or get overly defensive when others are critical. Pursues, responds to and appreciates feedback. Is a willing and patient listener. Authentically cares about people; is concerned about their work and non-work issues.
Advanced Other Possesses excellent oral, written and one-on-one communication skills. Holds others, at all levels of the organization accountable. Has the courage and is able to articulate constructive feedback regarding actions and performance to direct reports and others at all levels of the organization. Is able to make clear, concise and easily understood presentations to all levels of leadership across the system as well as at the physician, clinical and day-to-day operational levels. The ability to make the complex simple. A strong and active listener.
Advanced Other Ability to analyze and interpret financial data in order to coordinate the preparation of financial records. Demonstrate problem solving skills. Knowledge of healthcare delivery. Knowledge of community, state and federal laws and resources.
Advanced Other Ability to provide proactive approach and support to emerging business activities established to remain competitive in the marketplace.
Advanced Other Ability to motivate executives to achieve agreed-upon results.
Advanced Other Proven ability to affect change and meet business goals, monitor progress and take corrective action when necessary.
Advanced Other Strong business acumen, intelligence and capacity. Thinks strategically and implements tactically.
Advanced Other Ability to think creatively and out of the box. Ability to position the organization for the future, looking beyond the present situation to conceptualize key trends and identify changing market demands.
Advanced Other Comprehensive knowledge of healthcare operations, provider contracting, strategic planning and overall healthcare service delivery.