Full Job Description
The Market President leads Senior Focused Primary Care clinical operations in a multi-physician centers or clinical group setting, typically overseeing multiple centers within a market. This role is responsible for developing and executing a value-based market strategy, aligning with the overall goals of the Primary Care Organization. The Market President leads operations and ensures the smooth operation and performance of centers within their assigned accountability, handling a range of administrative, operational, growth, retention, and leadership tasks. This role partners closely with a dyad medical leader for the market as well, ensuring both the operational and clinical objectives are met. The market president role requires a strategic mindset, financial acumen, relationship-building and talent-developing proficiencies, strong organizational skills, communication competencies, and a passion for patient care.
Key Responsibilities:
Leadership & Operational/Organizational Management:
Assume responsibility for the financial performance (P&L) of the market, including membership growth and retention, clinic margin performance drive through value-based care (VBC) objectives and cost efficiency initiatives.
Responsible for overseeing and driving the projected growth rates and profitability performance of centers within the market.
Develop strategic relationships in collaboration with PCO contracting team with health plan payers, brokers, and community partners in the market, with sensitivity to potential partnership & growth opportunities.
Proficiency in monitoring and analyzing key performance indicators (KPIs) such as Membership, Retention, Patient Engagement, Access, Scheduling, Referral turnaround time, phone abandonment rates, PCP/voluntary alignment change forms, and more.
Monitor, manage and drive strategy from data analytics, scorecards, cost & utilizations, HCC coding, and NPS Scores, focusing on patient satisfaction and performance improvement to ultimately enhance patient outcomes and reduce downstream utilization.
Supervision and management of operational staff - guiding them on performance expectations and supporting their development, effectively executing organizational change management.
Ensure the market’s team of healthcare professionals and support staff are trained in the principles and practices of value-based care.
Engage in recruitment of operational and clinical staff, develop internal leaders, institute broad career pathing, prioritize succession planning, and foster continuous learning and improvement.
Responsible for contributing to leadership and financial discussions during regular meetings with operational and clinical leaders, utilizing exceptional presentation and facilitation skills to simplify complex information and engage audiences.
Clinical/Patient Experience:
Manage outpatient care teams to maintain high patient satisfaction, enable the best patient outcomes, and establish a strong brand in the community.
Ensure high levels of patient satisfaction by addressing clinician performance issues, in collaboration with clinical leadership; fosters a patient-centric environment in alignment with our CARE standards
Focus on patient outcomes and integrate VBC (Value-Based Care) principles into daily operations, ensuring operational and clinical excellence to meet and improve patient quality and outcomes.
• Oversee successful market patient service recovery opportunities, as needed, and any clinician concerns are discussed with clinical leadership to define any follow up action.
• Maintain an awareness of the competitive health care environment within the market and respond appropriately to any concerns.
• Maintain strong relationships with payer partners and local hospital systems
• Oversee successful market execution of quality gaps closure, including medication adherence
• Identify, partner and build clinical specialty network within market, collaborating with the centralized SNO team
• Oversee successful market execution of referral and medical record management
Dyad Partnership:
• Collaborate with the Chief Medical Officer and other clinical leaders to achieve shared goals, ensuring consistent communication and unified decision-making.
• Align on performance management, clinical and operational strategies, growth (sales and retention) tactics, presenting a unified voice to respective teams.
• Partner on operational budgeting and strategic planning, determining services, providers, and expected outcomes collaboratively.
• Focus on utilization management and review provider schedules to meet patient access goals, with biannual reviews of incentive plans.
• Monitor and communicate incentive and performance plans effectively.
• Collaborate to effectively manage performance, either within the clinical or operational team.
• Ensures regular center level dyad meetings are occurring and including clinical and operational leadership
• Ensure patient access across all centers overseeing balancing new patient access and acute needs for existing patients.
• Collaborate with HR Business Partners to understand and execute HR objectives
Required Qualifications:
Bachelor’s Degree.
10+ years of progressive leadership experience in large, complex, and integrated healthcare or payer setting.
5+ years of management experience in clinical care or related field, with experience driving results in a full-risk VBC environment.
Proven experience in clinical operations and financial management, including P&L responsibilities.
Strong understanding of healthcare regulations, compliance, and managed care.
Understanding of EMR systems, analytical processes, NPS, and other relevant software tools.
Must have a valid driver’s license as there will be travel between centers.
Ability to effectively lead in a changing environment and experience with change management is strongly desired.
Strong influencing skills, across matrixed environment.
Demonstrated interpersonal skills, enabling effective interaction both internally and externally with a diverse range of individuals, including physicians, office staff, hospital executives, medical groups, IPAs, community organizations, and other health plan staff.
Preferred Qualifications:
Master’s degree in health services or business administration.
Business development AND/OR experience successfully building out markets.
Expert knowledge of various external market forces affecting medical centers specific to relationships with hospitals, practitioners, and third-party payers.
Scheduled Weekly Hours
40
Pay Range
The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc.
$223,800 - $313,100 per year
This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance.
Description of Benefits
Humana, Inc. and its affiliated subsidiaries (collectively, “Humana”) offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities.