Director, Affiliate Operations & Contracting

  •  

Las Vegas, NV

Industry: Healthcare

  •  

5 - 7 years

Posted 51 days ago

This job is no longer available.

SUMMARY

Responsible for growing and managing the contracted primary care clinics assigned patients at risk through HealthCare Partners’ payor contracts. Primary responsibility is continued improvement in affiliated clinicians producing health care outcomes that demonstrate that safe, high quality care is cost effective. This is demonstrated through PCP engagement and adoption of the HCPN Total Care Model. This position drives growth and retention of patients assigned to Affiliated clinics through clinical operations that results in continuously improved performance and profitability.

ESSENTIAL FUNCTIONS

• Responsible for quality and continuous improvement within the job scope.

• Responsible for all actions/responsibilities as described in company controlled documentation for this

position.

• Contributes to and supports the corporation's quality initiatives by planning, communicating and

encouraging team and individual contributions toward the corporation's quality improvement efforts.

• Provide administrative and operational oversight of department; and coordinate the delivery of

medical services to Affiliate clinics which include multiple sites in the HCPN service area.

• Responsible for strategic planning, education, and financial operations of department, budget

management, patient and customer satisfaction, communication, clinical service delivery, operating

efficiency, staff retention and network growth.

• Plan, schedule and coordinate intervening activities at each of the Affiliate clinics to ensure all facilities

are well engaged in the Total Care Model.

• Document and administer policy and procedures for Affiliate Department to reduce unexplained

variation within deployment of the Total Care Model.

• Manage the fiscal results of the department, including budgeting and monthly financial and utilization

reporting and analysis, and continually creating and implementing strategies to improve performance.

• Collaborate with contracting units to improve all provider contracting and provider relation activities

that affect Affiliated primary care clinics.

• Responsible for coordinating, monitoring, and taking corrective action as needed to ensure the quality

of all services provided in support of the department.

• Ensure clinical quality by collaborating with the Affiliate Medical Director and serving as an resource

for clinical operational guideline questions and issues.

• Ensure quality control and performance improvement activities; create and gains support for strategic

plans, execute effective action plans, evaluate team and clinic performance, patient satisfaction

surveys and customer service achievements.

• Participate in the development, implementation and evaluation of marketing plans.

• Serve as company liaison to Affiliate clinics, and associated representatives.

• Responsible for excellence and continuous improvement within the job scope.

• Responsible for all actions/responsibilities as described in company controlled documentation for this

position.

• Direct and support the company’s quality initiatives, for instance support of 5 STAR initiatives, by

planning, communicating, and encouraging team and individual contributions toward the companywide

efforts.

• Support the delivery of high quality services to patients, providers, vendors, health plans, boards and

committees.

• Interface with managed and healthcare maintenance organizations.

• Provide the company’s senior executive team and committees with procedures and governance

standards, reports, and all required documentation.

• Establish work objectives and courses of action to achieve departmental, market, and corporate goals

and objectives.

EXPERIENCE REQUIREMENTS

• 5+ years experience in ambulatory care operations or healthcare management, including

demonstrated success driving performance and profitability, is required.

• Experience with contract negotiation and managed care administration between providers and

institutions is highly desired.

EDUCATIONAL REQUIREMENTS

• MBA or other advanced degree in healthcare administration, economics, sales or finance.

• Healthcareclinical education or training is highly desired (such as, nursing or allied health

professional)

KNOWLEDGE, SKILLS, ABILITIES

• Excellent interpersonal and communication skills. Demonstrated ability to establish, build and deepen

relationships with allied partners over time.

• A solid understanding of healthcare system and operations financial concepts is required. Must

possess the ability to utilize solid business model acumen to conduct strategic financial modeling, risk

and quality management, and interpret a variety of financial planning, performance and forecast

measurements.

• In-depth knowledge of the healthcare policies and trends affecting senior populations. A thorough

understanding of population management.

• Ability to implement new innovations to streamline procedures that support the Total Care Model,

and implement technologies to improve efficiency to ensure high standards of care.

• Solid time management skills, including the ability to manage multiple activities and competing

priorities.

• Outstanding problem identification and resolution skills.

• Exceptional communication (oral and written) skills and computer proficiency (e.g. Microsoft Office).

• Ability to coach internal team and external clients to improved performance and increase patient and

customer satisfaction.