Sr. Director, Network Engagement & Performance
Why This Role is Important to Us:
The Sr.
Director of Network Engagement and Performance will execute CCA's redefined Provider Integration Support Model.
She/He will lead a team of network management professionals working to implement network performance improvement strategies in collaboration with clinical, financial, and contracting leaders and other operational areas that interface with or impact providers.
He/She will be responsible for leading strategic discussions with internal and external leaders, developing a repeatable process to analyze, develop intervention strategies for specific providers and network by leveraging actionable performance information.
This includes delivering recommended strategies to network and internal leadership with the express requirement of predictable and improved provider financial performance, quality outcomes and member satisfaction.
She/e will build and strengthen relationships with key strategic provider partners, and internal departments with responsibility for ensuring an improved provider experience that leads to increased levels of provider-support shared growth of membership in CCA products.
She/He will be an active champion of change in advancing CCA's ability to deliver a simplified and predictable provider experience across all aspects of CCA's provider operating model.
She/He will work internal CCA team members and providers to identify barriers and deliver sustainable solutions.
Supervision Exercised:
Yes What You'll Be Doing:
Oversee the performance of specific strategic risk partners, health systems, Federally Qualified Health Systems, and multispecialty practices; this role will also be responsible for building responsive, high-performing relationships with new, strategic health systems as they come online with CCA.
Ensure clear financial, quality and member satisfaction goals are advanced in each applicable provider partnership.
For defined network provider, ensure the CCA network is cost effective, marketable, stable and offers appropriate access needed to meet member care needs.
Internal to CCA, develop and maintain clearly defined and closely coordinated relationships with departmental leaders, internal analysts, contract managers, clinical and operations functionsin support of clear provider-level strategies and plans for influencing performance.
Internal role clarity and how these roles coordinate as a single, aligned team is a critical responsibility of this role.
Continuously lead strategies to identify barriers to success, and in coordination with the cross-functional, aligned internal team, execute actionable changes impacting; cost, quality, plan/provider collaboration and operational efficiencies.
Translate strategy into defined tactics, programs/projects priorities.
Consistently achieve CCA, individual, and team performance goals/metrics.
Develop, mentor, and coach cross-functional team as well as influence the organization through modeling best in class strategies, execution discipline and leadership behaviors.
Established best practices to develop and maintain positive relationships between CCA and providers, and to influence and change behavior of providers in accordance with shared goals and performance objectives.
Modernize best practices within CCA by identifying and ensuring administrative simplification, revenue management advancement, digital road maps for secure and public websites, communication planning, and streamlining operational and project management practices used in driving successful provider performance and experience strategies.
Working Conditions:
Standard office conditions and work from home.
Travel to provider offices needed where applicable.
Position may require evening events in support of provider community.
What We're Looking For:
Education Required:
Bachelor's degree in health or business Administration or a related field required Education Desired:
Master's degree preferred (MBA, MPH, MA) Experience Required:
Established relationships in the Massachusetts provider community and in-depth knowledge of varying provider types and best practice interaction and service models.
Broad experience working in and across network management areas such as contracting, network operations, communications, network performance and provider relations developing, implementing, and successfully managing performance across various provider contractual relationships.
10
years' experience in the health care industry with increasing responsibility, including staff management
7
years prior experience (contracting, provider and/or hospital or physician offices); preference is primarily health plan experience.
Knowledge, Skills & Abilities Required:
Demonstrated ability to work across and influence high-performing teams in alignment of goals, work plans and consistent results.
Strong quantitative skills including the ability to identify trends, analyze and interpret financial and utilization data; application of these skills relative to the range of value-based contractual models.
Ability to organize and lead complex projects or initiatives with a history of consistently delivering results.
Deep understanding of health care marketplace and superior knowledge of provider performance trends.
History of demonstrating initiative and flexible thinking along with the ability to implement change and consistently identify course correction/improvement opportunities.
Language(s) Required:
English Other Required:
Standard office equipment EEO is The Law Equal Opportunity Employer Minorities/Women/Protected Veterans/Disabled Please note employment with CCA is contingent upon acceptable professional references, a background check (including Mass CORI, employment, education, criminal check, and driving record, (if applicable)), an OIG Report and verification of a valid MA/RN license (if applicable).
Commonwealth Care Alliance is an equal opportunity employer.
Applicants are considered for positions without regard to veteran status, uniformed service member status, race, color, religion, sex, national origin, age, physical or mental disability, genetic information or any other category protected by applicable federal, state or local laws.
Recommended Skills Administration Business Administration Clinical Works Coaching And Mentoring Communication Contract Management Estimated Salary: $20 to $28 per hour based on qualifications.
The Sr.
Director of Network Engagement and Performance will execute CCA's redefined Provider Integration Support Model.
She/He will lead a team of network management professionals working to implement network performance improvement strategies in collaboration with clinical, financial, and contracting leaders and other operational areas that interface with or impact providers.
He/She will be responsible for leading strategic discussions with internal and external leaders, developing a repeatable process to analyze, develop intervention strategies for specific providers and network by leveraging actionable performance information.
This includes delivering recommended strategies to network and internal leadership with the express requirement of predictable and improved provider financial performance, quality outcomes and member satisfaction.
She/e will build and strengthen relationships with key strategic provider partners, and internal departments with responsibility for ensuring an improved provider experience that leads to increased levels of provider-support shared growth of membership in CCA products.
She/He will be an active champion of change in advancing CCA's ability to deliver a simplified and predictable provider experience across all aspects of CCA's provider operating model.
She/He will work internal CCA team members and providers to identify barriers and deliver sustainable solutions.
Supervision Exercised:
Yes What You'll Be Doing:
Oversee the performance of specific strategic risk partners, health systems, Federally Qualified Health Systems, and multispecialty practices; this role will also be responsible for building responsive, high-performing relationships with new, strategic health systems as they come online with CCA.
Ensure clear financial, quality and member satisfaction goals are advanced in each applicable provider partnership.
For defined network provider, ensure the CCA network is cost effective, marketable, stable and offers appropriate access needed to meet member care needs.
Internal to CCA, develop and maintain clearly defined and closely coordinated relationships with departmental leaders, internal analysts, contract managers, clinical and operations functionsin support of clear provider-level strategies and plans for influencing performance.
Internal role clarity and how these roles coordinate as a single, aligned team is a critical responsibility of this role.
Continuously lead strategies to identify barriers to success, and in coordination with the cross-functional, aligned internal team, execute actionable changes impacting; cost, quality, plan/provider collaboration and operational efficiencies.
Translate strategy into defined tactics, programs/projects priorities.
Consistently achieve CCA, individual, and team performance goals/metrics.
Develop, mentor, and coach cross-functional team as well as influence the organization through modeling best in class strategies, execution discipline and leadership behaviors.
Established best practices to develop and maintain positive relationships between CCA and providers, and to influence and change behavior of providers in accordance with shared goals and performance objectives.
Modernize best practices within CCA by identifying and ensuring administrative simplification, revenue management advancement, digital road maps for secure and public websites, communication planning, and streamlining operational and project management practices used in driving successful provider performance and experience strategies.
Working Conditions:
Standard office conditions and work from home.
Travel to provider offices needed where applicable.
Position may require evening events in support of provider community.
What We're Looking For:
Education Required:
Bachelor's degree in health or business Administration or a related field required Education Desired:
Master's degree preferred (MBA, MPH, MA) Experience Required:
Established relationships in the Massachusetts provider community and in-depth knowledge of varying provider types and best practice interaction and service models.
Broad experience working in and across network management areas such as contracting, network operations, communications, network performance and provider relations developing, implementing, and successfully managing performance across various provider contractual relationships.
10
years' experience in the health care industry with increasing responsibility, including staff management
7
years prior experience (contracting, provider and/or hospital or physician offices); preference is primarily health plan experience.
Knowledge, Skills & Abilities Required:
Demonstrated ability to work across and influence high-performing teams in alignment of goals, work plans and consistent results.
Strong quantitative skills including the ability to identify trends, analyze and interpret financial and utilization data; application of these skills relative to the range of value-based contractual models.
Ability to organize and lead complex projects or initiatives with a history of consistently delivering results.
Deep understanding of health care marketplace and superior knowledge of provider performance trends.
History of demonstrating initiative and flexible thinking along with the ability to implement change and consistently identify course correction/improvement opportunities.
Language(s) Required:
English Other Required:
Standard office equipment EEO is The Law Equal Opportunity Employer Minorities/Women/Protected Veterans/Disabled Please note employment with CCA is contingent upon acceptable professional references, a background check (including Mass CORI, employment, education, criminal check, and driving record, (if applicable)), an OIG Report and verification of a valid MA/RN license (if applicable).
Commonwealth Care Alliance is an equal opportunity employer.
Applicants are considered for positions without regard to veteran status, uniformed service member status, race, color, religion, sex, national origin, age, physical or mental disability, genetic information or any other category protected by applicable federal, state or local laws.
Recommended Skills Administration Business Administration Clinical Works Coaching And Mentoring Communication Contract Management Estimated Salary: $20 to $28 per hour based on qualifications.
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