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VP of Network Operations
4 months ago
DC Primary Care Association (DCPCA) works to create healthier communities through advocacy and the development of the infrastructure to support a high quality, equitable, integrated health care system that gives every DC resident a fair shot at a full and healthy life.
POSITION SUMMARY:
The Vice President of Network Operations will support the CEO of DC Primary Care Association (DCPCA) and facilitate planning, development, implementation, and ongoing management of the DC Connected Care Network (DC-CCN). The VP of Network Operations will ensure that the Network performance aligns with MCO contracting metrics and enable successful Network performance. The successful candidate for this role will be required to work in the DCPCA office at least three (3) days a week. However, DCPCA also offers an alternative 5-4/9 compressed work schedule.
ESSENTIAL DUTIES AND RESPONSIBILITIES:
Work effectively with community health center leadership and clinical teams to meet MCO VBC contracting terms and performance requirements.
Stays up to date with current industry and market trends and best practices on financial elements, program structures, ad best practices.
Leads the design and negotiation of new value-based contracts with MCOs.
Coordinate with leadership to develop, implement and support the infrastructure of DC-CCN including but not limited to data and analytics systems, clinical practice transformation support and technical assistance, supports the success and accountability for the Network subcommittees.
Establish regular communication and a working relationship with Medicaid MCOs for network development and to monitor performance, stay attuned to market changes and MCO and stakeholder managed care contract priorities.
Responsible for monitoring results and maintaining the operational effectiveness of the DC-CCN through relevant metrics established in the areas of quality outcomes, access, and cost-effectiveness and proactively identifies issues and proposes actions and recommendations to boost program performance.
Work with the DC-CCN clinical leadership to support the implementation of programs designed to ensure the use of best practices, continuous outcomes improvement, and the appropriate level of care coordination/transitions in care management for the level of severity of each patient.
Collaborate with IT leadership and other entities to ensure processing of monthly claims data, regular reporting of summative quality data, patient attribution lists, utilization and cost of care data, timely risk adjustment and population segmentation.
Assist with budget development, develops models to forecast total cost of care and utilization performance, oversee adherence, and resource allocation as deemed necessary for success.
Identifies and implements approved strategic partnerships to enhance performance of the network.
Collaborates with DC-CCN leaders to share specific program performance opportunities with health center leadership.
QUALIFICATIONS, KNOWLEDGE & SKILL REQUIRED:
Advanced degree in Health Care Management/Administration preferably in Business Administration, Public Health, or related field.
Five or more years of healthcare leadership and management experience with demonstrated ability in managed care contracting, practice transformation, Value based care performance tracking and systems change.
Specific experience in practice transformation, and documenting clinical value with improved processes, outcomes and the lowering of the cost of care. Ability to optimize performance under total cost of care savings and shared risk contracts.
Knowledge of federally qualified health centers, population health, care continuum, value-based care, managed care contracting and strategy, and population-based quality programs.
This position is primarily sedentary in the Washington DC office with occasional overnight travel and may require some bending and lifting. DCPCA is a fast-paced, high-energy organization with a very ambitious agenda and a staff that is highly motivated. This position may experience high work demands under tight timelines.
DCPCA offers a comprehensive benefits package that includes health, dental, vision, retirement, and paid leave.
DCPCA is an Equal Opportunity Employer.
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