Director Operations Triad HealthCare Network

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Job description

Overview:

The Director Operations Triad HealthCare Network (THN) provides the leadership, management, and vision necessary to help ensure the company has the proper operational controls, administrative, and reporting procedures in place to effectively grow the organization and to help ensure financial strength and operating efficiency. As the Director Operations of our value-based, clinically integrated network and Accountable Care Organization (ACO), you will play a pivotal role in driving operational excellence, fostering clinical integration, and ensuring the delivery of high-quality, cost-effective care to our patient population. Reporting directly to the CAO, you will lead strategic initiatives, optimize organizational processes, and cultivate collaborative relationships with stakeholders to achieve our mission of improving patient outcomes while reducing healthcare costs. A critical function of this role is to partner with leaders across the organization to drive overall revenue, quality performance, clinical outcomes, and member / physician experience. This role will be directly accountable for the internal operations of THN up to and including network support teams; practice transformation teams and partnering with CAO to ensure financial performance of THN is met. The Director Operations will ensure the company maintains regulatory compliance guidelines.

Talent Pool: Leadership

Responsibilities:

Provides leadership and overall direction for internal network operations, supports and helps to drive marketing and communication initiatives, and member experience functions to deliver expected business results. Develops and implements short and long range strategic and tactical plans, goals, and objectives to help achieve profitable growth. Responsible for collaborating and developing strategic and tactical plans to help achieve efficient and effective operations, membership growth, quality goals, and revenue goals. Reports operational performance to executive leadership and the Board of Directors.

Accountable for leading, managing, and coordinating THN operations, including but not limited to management services value stream contracts/vendors; network support operations up to and including call center, claims resolution issues, and enrollment; collaborates with Director of contracting with on all Payors and ACO initiatives and helps to ensure compliance with Centers for Medicare & Medicare Services, federal and state laws and regulations under all ACO / MSSP contract initiatives. Oversees the practice transformation teams and all aspects of internal operations of THN.

Works with leadership to evaluate the competitive positioning of products in the marketplace and collaborate on the development of network strategy to achieve growth, profitability, and quality and performance goals.

Works to development and implementation strategic marketing and communications plans to achieve corporate objectives for profitability and growth; assists and directs marketing and ACO activities.

Effectively Leads staff & works with physician member experience functions; provides consistent guidance and mentoring of staff; and builds effective teams (both internally, externally and with vendors) to achieve established goals and within established budgets. Demonstrates the ability to lead and influence others positively to achieve desired goals. Establishes and maintains a positive working relationship with practices, physicians, key stakeholder leaders throughout THN, CHMG, Cone Health and all affiliates, its shareholders, regulatory agencies, and vendors.

Data Analysis and Reporting
- Analyze practice performance data to identify trends, patterns, and areas for intervention.
- Prepare regular reports and dashboards to communicate practice performance metrics, progress on transformation goals, and opportunities for improvement.

Collaboration and Communication
- Collaborate with other members of the CIN and Value Based Institute leadership team, analytics, and IT teams, including clinical, administrative, and operational stakeholders.
- Serve as a liaison between the internal physician practice transformation team and external partners, such as payers, regulatory agencies, and community organizations.

Qualifications:

EDUCATION:

REQUIRED:
Master's Degree in healthcare administration, public health, nursing, or a related field is required. Bachelor's degree plus PharmD; or other professional certification or license will be considered with 5+ years leadership experience.

Member of ACHE and/or MGMA

PREFERRED:
Master's degree in healthcare admin or business administration, or related field.

FACHE

EXPERIENCE:

REQUIRED:
10+ years of health care experience in a variety of roles

7+ years of leadership experience

5+ years leading operations in a complex, matrix organization

5+ years creating and executing business strategies

REQUIRED:
Experience working with Centers for Medicare & Medicaid Services, Managed Care Plans, and Employer Groups

Experience with product development and competitive analysis

Strong in Word, Excel, and PowerPoint

Expertise in working with EMR platforms

Expert in oral and written communications

Position will be required to assist and lead conversations in formal Committee structures and leadership forums.

Position requires strong emotional intelligence and ability to effectively communicate.

Executive level communication and influence skills

Strong in the following competencies:
- Decision Making/Judgment
- Problem Solving/Analysis
- Creativity/Innovation

Self-motivated with excellent follow through

Ability to work independently and with a team

PREFERRED:
Experience leading/ coordinating large projects

LICENSURE/CERTIFICATION/REGISTRY/LISTING:

REQUIRED:

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