Vice President, Participant Network Management
- Health Current
- Location: Phoenix, Arizona
- Category: Executive-Administrative Vice President Nonprofit-Executive Philanthropy-Administrative-Non-profit
- Posting Date: 10/13/2021
- Application Deadline: Open until filled
Health Current is the health information exchange (HIE) that helps partners transform care by bringing together communities and information across Arizona. More complete information is more meaningful and leads to better care and better outcomes. It makes healthcare transformation possible. That is why we have worked for more than ten years to become Arizona’s primary resource for information technology and exchange, integrating information with the delivery of care to improve the health and well-being of individuals and communities. As we have grown, our core goal has remained the same: help providers use information technology to improve people’s lives.
CORHIO (the Colorado Regional Health Information Organization) is an independent, nonprofit organization dedicated to improving healthcare quality through the optimal use of health information exchange (HIE). The CORHIO HIE is one of the largest and most robust health information exchange networks in the United States with 74 hospitals and more than 6,900 office-based providers currently connected. In addition to managing the robust HIE network, CORHIO provides advisory services that help healthcare professionals effectively use electronic health records and improve care delivery, and supplies accountable care organizations and health plans with data that enhance population health programs.
Effective July 1, 2021, Health Current and CORHIO merged to form a regional health information exchange, Contexture. As a central source for health information services across both states, CORHIO and Health Current are pursuing this strategic alignment to demonstrate an effective model for community-driven healthcare interoperability that can be implemented nationwide. For more information visit our Contexture website at: www.contexture.org.
Under executive direction of the Chief Business Development Officer (CBDO), the VP Network Management oversees development and management of the network of healthcare organizations and entities participating in Contexture. The position leads network strategy and operations including developing and implementing strategic expansion plans, executing revenue-driven sales initiatives, and achieving network growth goals.
The VP Network Management oversees stakeholder and community outreach, collaboration and alignment with health and technology initiatives in the healthcare ecosystem. This position will also maintain confidentiality of all privileged information. This position will be based in Phoenix, Arizona or Denver Colorado.
Essential Duties and Responsibilities include the following:
- Network Management and Growth.
- Coordinates with Contexture and departmental leadership to conduct regular analyses of the participant network from a cost, coverage, and growth perspective.
- Identifies and responds to new opportunities related to use of Contexture data in innovative ways, including grants, academic partnerships, cooperative agreements, and state agency programs.
- Provides periodic updates and reports on network management, market research and development projects and programs and maintains alignment with overall company business and strategic goals.
- Establishes the department’s annual growth plan and targets and develops outreach strategies and campaigns aligned with target markets. Cascades growth goals to staff via incentive and performance measure strategies.
- Develops, inspires, and sustains a sales workforce that is knowledgeable, enthusiastic, and skilled in identifying participant needs and linking Contexture data to their business and clinical goals.
- Supports the contract development and execution process for new participants and new service/product sales.
- Assists CBDO and other executives in formulating data-driven expansion strategies and develops metrics and reports monitoring progress toward goals.
- Network Development and Operations
- Compiles market research for targeting products, services, and initiatives to local and regional stakeholder audiences. Collaborates with sales teams to propose strategies based on target healthcare markets.
- Oversees analysis of claims, provider and licensing data and other market information to derive trends in healthcare delivery, key provider groups and their overall value to Contexture. Develops reports for leadership on market status, risks, and potential opportunities.
- Creates healthcare provider profiles, market summaries and tools to support new and changing growth targets.
- Oversees the credentialing/verification function for new and existing participants, ensuring accurate and high-quality capture and documentation of network data within the company customer management system. Creates reports and marketing information that describe the current status of the participant network.
- Develops internal policies and systems for ensuring compliance with company and regulatory requirements affecting participation in the network, including HIPAA, 42 CFR 2 and information blocking regulations.
- Identifies technology, resources and procedure improvements for increased efficiencies, accuracy, and continuous process enhancements.
- Develops and administers the departmental budget and provides oversight for subdepartment budget planning and accountability.
- Health Initiatives
- Supervises the community outreach and engagement function, focused on cultivation and development of positive stakeholder and community relations within and across multiple states.
- Supports special programs and state-specific initiatives focused on value-based purchasing and healthcare integration, including the Differential Adjusted Payment and Targeted Investments programs.
- Creates customer tools and educational programs supporting advanced use of the Contexture products and services, and packaging of those products and services for specific healthcare sectors and markets.
- Assists in fostering and development of relations and initiatives with academic partners and internship/fellowship programs.
- Oversees the grants acquisition and development process.
- Other duties as assigned.
To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
- Thorough knowledge of a diverse range of healthcare organizations and entities, including hospitals, physician groups, ancillary providers, pharmacy, behavioral health, and long-term care, as well as health plans and accountable care organizations. Understanding of business models, drivers, and technology adoption within these settings.
- Proven success in achieving and surpassing key performance metrics, including membership growth, provider performance and financial targets.
- Working knowledge of federal and state regulations governing health information privacy and health information organizations.
- Strong written, verbal, and presentation skills. Ability to effectively present information and respond to questions from senior management to physicians and other healthcare providers.
- Ability to shift from a high-level strategic focus regarding initiatives to a detail-oriented taskdriven focus as well as working concurrently on a variety of tasks/projects with competing deadlines and turnaround times.
- Ability to motivate, engage and develop staff, building trust and consensus, and appropriately delegating and empowering a high-caliber professional team.
- Ability to analyze varied data and reports and identify trends and variances. “Big Picture” thinking.
- Strong computer skills, Word, Excel, Access, PowerPoint, and office equipment.
- Must have advanced reasoning and highest level of problem solving and planning skills
- Energetic, self-reliant, good problem solver, and results oriented.
- Promotes a culture of high performance and continuous improvement that values learning and a commitment to quality.
- Thrives in a fast-paced, collaborative environment with a high-volume workload often requiring short turnaround times.
Bachelor's degree or equivalent experience in Business Administration, Healthcare Administration, or related field. MBA or MHA degree preferred. 7+ years of experience in managed care network development and provider relations/contracting management in a health care and/or managed care environment, preferably with direct provider interaction. Previous management experience including responsibilities for hiring, training, assigning work and managing performance of staff.
The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. The noise level in the work environment is usually moderate.
The position may require occasional availability for after-hours work, outside of regularly scheduled hours.
The position may require ability to periodically drive to and from clients, conferences and / or events; and / or limited travel.
This position is expected to be exposed to, process, or handle sensitive information including but not limited to Protected Health Information (PHI), Personally Identifiable Information (PII), financial information, etc. As such, the holder of this position is expected to comply with all applicable laws, regulations, organizational policies, and compliance expectations.
The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. The person in this position needs to frequently communicate and exchange information and move about inside the office to access file cabinets, office machinery, etc. Must be able to remain in a stationary position 50% of the time. Constantly operates a computer and other office productivity machinery, such as a keyboard, monitor, calculator, copy / scanner machine, and printer. Frequently moves office and work-related material weighing up to 10 pounds; Occasionally moves office and work-related material weighing up to 30 pounds.
Reasonable accommodations may be made to enable individuals with disabilities to perform essential functions.
Note: This job description is not intended to be an exhaustive list of all duties, responsibilities and / or qualifications associated with the job.
Benefits: The organization provides a comprehensive benefits package. For details, please request a Benefit Summary from Human Resources.
The organization is an inclusive Equal Opportunity Employer. We do not discriminate on the basis of race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or other status protected by law or regulation.