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Sr Director, Managed Care/MSO
4 months ago
Job Description
The Administrative Director of MSO is a seasoned, strategic and process minded leader. Directs and oversees the daily operations of the MSO, as well as all functions related to provider contracting, utilization management, quality management, network management and claims. Participates in the strategic planning process and works closely with the VP Managed Care Operations. Establishes and executes initiatives leading to growth, financial performance and provider relations.
PIH Health is a nonprofit, regional healthcare network that serves approximately 3 million residents in the Los Angeles County, Orange County and San Gabriel Valley region. The fully integrated network is comprised of PIH Health Downey Hospital, PIH Health Good Samaritan Hospital, PIH Health Whittier Hospital, 37 outpatient medical office buildings, a multispecialty medical (physician) group, home healthcare services and hospice care, as well as heart, cancer, digestive health, orthopedics, women's health, urgent care and emergency services. The organization is nationally recognized for excellence in patient care and patient experience, and the College of Healthcare Information Management Executives (CHIME) has identified PIH Health as one of the nation's top hospital systems for best practices, cutting-edge advancements, quality of care and healthcare technology. For more information, visit PIHHealth.org or follow us on Facebook, Twitter, or Instagram.
Required Skills
Strong working knowledge of current ambulatory healthcare industry, as well as, managed care experience working with Department of Managed Care.
Excellent interpersonal and leadership skills, capable of earning respect, confidence and credibility of peers and team members.
Excellent verbal, written, interpersonal and communication skills with the ability to make presentations to various groups of the organization(s) including presentations to multiple Board of Directors.
Well organized and able to multi-task.
Critical thinker who demonstrates problem solving skills for complex real world scenarios
Understands, in detail, the daily, weekly, monthly and yearly metrics of the MSO and is able to make adjustments to hit predefined goals/objectives
Strong understanding of computer systems that support the operations of the IPA
Ability to build strong relationships with the health plans and the DMHC.
Required Experience
Required:
Minimum of a bachelor's degree; ideally with and MBA or MHA
IPA and managed experience
Excellent people skills with an ability to partner with a dynamic leadership team.
Strong operational experience; ideally in a senior role in an integrated delivery system organization
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