VP, Value Based Care

UHS•Reno, NV

10h

About The Position

VP, Value Based Care leads and manages the implementation and national expansion of value-based program strategy and relevant client service models consistent with the goals of Prominence Health and Universal Health Services. This role is ultimately accountable for all value-based program outcomes, both quality and financial, as well as business alignment efforts targeted toward expansion of the UHS/Prominence Health national value-based care footprint. The incumbent will champion outcomes based initiatives and market-alignment activities contributing toward goal of highly integrated health care systems across the nation, within current UHS markets and through expansion to new locations. This individual will play a key role in representing Prominence Health as the value-based engine of UHS to internal stakeholders and external partners. VP, Value Based Care will be responsible for establishing and implementing outcomes-based programs and necessary supporting client service models at a national level tailored to individual market needs, demonstrating proven results through population health centric models and collaborating with internal and external key executives to ensure that value-based contracts align with the overall Company’s strategy. This incumbent is a key part of Prominence’s strategic imperative to achieve its share of care and PCP-alignment goals, as well as the goal of building the provider capacity necessary to support UHS’s clinical integration strategy through engaged, value and performance based oriented providers across the country. As a member of Prominence’s senior leadership team, the incumbent will be accountable with other senior leaders for achieving Prominence’s financial, quality, and service goals. In addition, the incumbent will represent Prominence in UHS workgroups working on clinical integration and population management.

Requirements

Bachelor’s degree required. Master’s degree in Healthcare or MBA preferred.
Minimum 8 years’ healthcare management experience working with both fee-for-service and value-based contracting.
Experience in value-based reimbursement methodologies and understanding the impact of financial results.
Demonstrated ability to develop and execute a provider network strategy that leads to clinical integration, value-driven networks.
Extensive experience with risk and value-based reimbursement models for physicians and hospitals and ability to communicate these models to providers and Prominence staff.
Experience in working with physician profiling software such as Verisk and Crimson.
Extensive experience with the full range of network development, ranging from selecting providers, contracting, credentialing, provider feedback, to provider services.
Demonstrated ability to build a highly functioning team and to mentor direct reports.
Experience with NCQA processes.
Experience with Commercial, self-funded, and Medicare Advantage network requirements.
Proven ability to foster collaboration between divergent stakeholders.
High degree of credibility with key stakeholders based on past accomplishments.
Experience in negotiating complex provider reimbursement arrangement.
Proven ability to drive organization through cultural change, focused on individual accountability and performance.
Solid understanding of health plan key financial drivers.
Excellent analytical skills applied in selecting and profiling providers.
Solid understanding of medical coding terminology used by physicians and facilities.
Ability to effectively communicate in English, both verbally and in writing.
Excellent communicator who is equally comfortable with external stakeholders as well as internal stakeholders.
Strategic but practical thinker that can take concepts from its initial stage through implementation to administration.
Ability to establish and maintain strategic relationships with providers and payors.
Service excellence orientation toward external and internal stakeholders.
Ability to interpret complex contract information.
Technologically adept to drive efficiency and effectiveness through Social Media, web portals, and workflow automation.

Nice To Haves

Master’s degree in Healthcare or MBA preferred.

Responsibilities

Leads and manages the implementation and national expansion of value-based program strategy and relevant client service models
Accountable for all value-based program outcomes, both quality and financial
Champions outcomes based initiatives and market-alignment activities
Establishing and implementing outcomes-based programs and necessary supporting client service models at a national level tailored to individual market needs
Collaborating with internal and external key executives to ensure that value-based contracts align with the overall Company’s strategy
Accountable with other senior leaders for achieving Prominence’s financial, quality, and service goals
Represent Prominence in UHS workgroups working on clinical integration and population management.