Vice President, PCO MSO – Value Based Services
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Job Description
Vice President responsible for growth and operations at Humana within the CenterWell Primary Care Organization. Leading multiple areas across contracting, credentialing, and value-based services for healthcare delivery.
Responsibilities:
- Create and build out national MSO and market-based IPA strategies, and products for Primary Care Organization
- Key initiatives including setting performance standards, deploying strategies to grow membership, proactively identifying value-added partners, creating high value products, and enabling expansive networks
- Develop innovative partnership opportunities with primary care practices in the marketplace to grow our Managed Service (MSO) business, including identifying partnerships, and recruiting sought-after IPAs
- Explore opportunities to grow the IPA business inorganically to accelerate capability development and/or accelerate market capture
- Assume joint responsibility for the financial performance (P&L) of the MSO, IPA growth, including setting KPIs, developing long term plans to meet financial targets
- Responsible for the PCO Contracting function
- Develop multi-year, mutually beneficial strategic partnerships externally with health plan payers, brokers and community partners in the market with sensitivity to potential partnership & growth opportunities
- Oversee the development and growth of CenterWell’s OM book of business across all value based programs current and future
- This role is responsible for developing detailed national, and market strategies which align to the overall goals of the Primary Care Organization
- Collaborate with market clinician and operations leadership to determine initiatives that will drive clinical performance, improve health outcomes, grow and retain membership, and reduce claims cost
- Oversee and support the transformation and technology enablement of the PCO Credentialing function
- Partner in dyad structure with operations and clinical leadership of all existing IPA practices across 7+ states
- Success in this position shall be measured across several key performance indicators including but not limited to: Financial and Clinical outcomes, Operational performance outcomes, Membership growth and retention, Patient satisfaction, Physician engagement/satisfaction
Requirements:
- Bachelor’s Degree
- 10+ years of progressive leadership experience in large, complex, and integrated healthcare delivery or health insurance setting
- Experience in healthcare management and/or operations, Provider Practice/Healthcare or medical center operations
- Demonstrated ability to work effectively with physician and health system leadership
- Proven ability to drive strategy, set and meet established targets, and create and deploy clinical products
- Strong relationship building, communication, organizational and team building skills
- Business development AND/OR experience successfully building out markets
- Expert knowledge of various external market forces affecting medical centers specific to relationships with providers and third-party payers
- Strong influencing skills, across matrixed environment
- Ability to work Eastern Standard Time
- Ability to travel 25% of the time across 7 states to include: WA, FL, TX, GA, TN, AZ, NV, UT
Benefits:
- Health insurance
- 401(k) matching
- Flexible working hours
- Paid time off
- Remote work options
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