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Senior Vice President of Operational Excellence

2 months ago

Portland, Oregon, United States CareOregon Full time
Job Title

Senior Vice President of Operational Excellence

Exemption Status

Exempt

Department

Operations Administration

Manager Title

Chief Operations Officer

Direct Reports

Vice President, Operations and Vice President, Network Operations

Requisition #

23890

Pay and Benefits

Estimated hiring range $226,700 - $274,300 / year, 15% bonus target, full benefits.

Posting Notes

This hybrid role will involve collaboration with various stakeholders in the Portland Metro area.

Job Summary
This position is accountable for the strategic direction and operational excellence of shared services at CareOregon. Responsibilities encompass various business lines, focusing on core enterprise operations and innovative solutions.

The role includes developing and executing a comprehensive strategy for both internal and external clients, ensuring the delivery of dependable, efficient, and scalable services.

Primary Duties
Strategic Leadership
Provide visionary leadership to operations departments, cultivating a culture of quality, collaboration, accountability, compliance, and continuous improvement.
Manage multiple complex, large-scale projects concurrently, maintaining focus on priorities, status, and risks.

Act as the enterprise leader for provider network management, member enrollment, and claims across all business lines, including Medicaid, Medicare, Behavioral Health, and Dental Health.

Ensure successful achievement of departmental goals, metrics, and KPIs across all service lines.
Assess and advise on the implications of long-term planning, new program introductions, and regulatory changes.
Oversee the execution of provider engagement and network strategies; contribute expertise to member engagement strategies and support their integration.

Provide insights to Value-Based Payment/Contracting teams implementing operational, clinical, and alternative payment initiatives to strategically position CareOregon for future success.

Facilitate collaboration between enterprise matrixed teams, shared services, and regional business lines.

Advise executive leadership on emerging market trends, best practices, and technology solutions for core operations and provider network management.

Strategic Planning
Engage regularly in strategic planning and collaboration at the organizational level.
Offer guidance to executive leadership on short and long-term planning initiatives.
Support assessments of emerging opportunities involving new companies or strategic partnerships.
Lead the formulation of vision and goals for areas of oversight.
Maintain a comprehensive understanding of CareOregon's operations and strategic functions, including strengths and potential threats.
Financial/Resource Management
Develop, propose, and oversee significant budgets aligned with strategic planning and organizational needs.
Advise on financial and labor allocations throughout the organization.
Relationship Management
Establish and nurture strategic relationships related to network resilience, VBP contracting, quality improvement, and clinical integration programs.

Support strategic relationships with provider stakeholders to ensure claims payment accuracy and innovative network arrangements.

Ensure that strategic messages are effectively communicated to relevant internal and external stakeholders.

Employee Supervision
Direct teams, establishing direction and goals aligned with the organizational mission and values.

Identify staffing needs; recruit, hire, and manage a diverse team to meet operational requirements.

Set departmental priorities; ensure employees have the necessary information and resources to meet expectations.

Lead the development and communication of team and individual goals; ensure clarity of expectations and standards.

Coach, motivate, and guide employees; promote professional development.
Incorporate equity, diversity, and inclusion principles into leadership and decision-making processes.

Evaluate employee performance and provide constructive feedback to support success.

Organizational Responsibilities
Perform work in alignment with the organization's mission, vision, and values.

Support the commitment to equity, diversity, and inclusion by fostering a culture of respect and understanding.

Strive to meet annual business goals in support of the organization's strategic objectives.

Adhere to organizational policies and compliance requirements.

Perform additional duties as necessary.

Experience and/or Education
Required
Minimum 10 years of relevant experience, including:
- 5 years of network management experience in managed care
- 5 years of health plan operations experience
Preferred
Minimum 5 years in a supervisory role
Knowledge, Skills, and Abilities Required
Knowledge
- Advanced understanding of managed health care and provider network relationships
- Comprehensive knowledge of clinical workflows and electronic health record systems
- Strong grasp of statistical methodologies for program assessment
- Understanding of financial structures and the economic impact of business decisions
Skills and Abilities
- Effective leadership and change management skills
- Ability to negotiate complex contractual relationships
- Exceptional relationship-building capabilities
- Strong presentation and communication skills
- Ability to develop and lead high-performing teams
- Strong analytical and problem-solving skills
- Ability to work effectively with diverse groups
- Ability to manage stress and adapt to feedback
Working Conditions
Work Environment(s): Indoor/Office Community Facilities/Security Outdoor Exposure
Member/Patient Facing:
No Telephonic In Person
Hazards:
May include physical and ergonomic hazards.
Equipment:
General office equipment
Travel:

May involve occasional travel outside of the workplace; personal vehicle or local transit may be utilized.

Candidates of color and veterans are strongly encouraged to apply. CareOregon is committed to fostering a diverse and inclusive work environment.

This organization considers all candidates regardless of race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or veteran status.