Associate Vice President - Network Performance & Analytics - Clinically Integrated Network

GENERAL SUMMARY:

The Associate Vice President-Network Performance & Analytics has responsibility for driving and leveraging data to achieve Network-wide and practice-specific achievement of clinical and financial performance and payor contract targets across a large pluralistic clinically integrated network of participating providers including employed medical groups, provider associations, independent providers, and facilities. This includes leadership oversight and direction for analytics functions, practice transformation, payor initiatives, and data-driven provider performance management systems to achieve network clinical and financial goals and deliver value to participating practices/providers across regional geographies.

PRINCIPLE DUTIES AND RESPONSIBILITIES:

• Optimizes performance of a diverse portfolio of analytics, practice transformation interventions, and payor initiatives to successfully execute on value propositions that position the system for successful transition to risk-based performance contracts.
• Develops and implements operational and analytics-driven systems to facilitate successful execution of payor and provider performance outcomes.
• Responsible for understanding financial opportunity and ongoing performance of payor-based initiatives/incentives, leveraging data and analytics to identify and deploy strategic priorities for focused intervention.
• Provides oversight to network practice transformation, payor program, and analytics teams to facilitate identification and implementation of best practice and innovative approaches to practice transformation and successful execution of performance outcomes and contractual obligations/targets.
• Leads payor performance teams in identification and implementation of innovative approaches to delivery and evaluation of integrated programs, education, measurement, reporting, and analytics tools to ensure high impact for a large volume of payors, practices, and patients.
• Acts as PO administrator for CIN payor performance programs including PGIP/PCMH and serves as liaison/accountable partner to payors as it relates to execution of contract terms and performance management.
• Leads provider performance management activities including reporting, rounding, action plans and other provider performance management activities, leveraging data and performance insights to ensure compliance with network and payor standards.
• Facilitates partnerships across CIN, health system, and medical group leadership, including system analytics and team members to create alignment, reduce duplication of efforts and maximize clinical and financial performance under risk contracts.
• Provides insight to Contracting leadership regarding performance opportunities and targets.
• Partners with Clinical Transformation leadership on achievement of Network clinical program or payor cross-continuum initiatives that require practice transformation engagement.
• Partners with Finance to track and project financial performance on payor-based initiatives/incentives and administrative funding according to network contracts.
• Effectively delegates work, communicates goals, establishes timelines, monitors accountability, and provides support to activities related to practice transformation and population health.
• Provides administrative leadership in resolution of high-level operational issues on behalf of the network and its customers.
• Establishes successful working relationships, ensures open communication, and interacts effectively with committee and board members, network and health system leadership, providers, practice managers, community partners, management, and staff to facilitate alignment of resources and execution of initiatives set forth by CIN, payors, and the community.
• Attends and assists with committee meetings of the Board on a regular basis and participates in committees as deemed pertinent by leadership.

EDUCATION/EXPERIENCE REQUIRED:

• Master's degree in Health Sciences, Business, Health Care Administration, or related field.
• Seven (7) years progressive leadership experience in large healthcare system, physician organization, managed care, and/or insurance environment with proven track record in healthcare operations management. This experience should include working with physicians and other clinical leaders in a multidisciplinary environment, with record of working across organizational lines to achieve excellence in outcomes.
• Five (5) years of experience providing leadership for provider/clinical/payor performance management including clinical integration and value-based contracts. This experience should include providing strategic leadership around payor initiatives to achieve value-based and risk-based contract targets.
• Three (3) years of experience leading practice-based transformation strategies resulting in demonstrated clinical and financial performance improvements.
• At least three (3) years of experience in a clinically integrated network preferred.
• Experience leading transformation in large pluralistic PO/clinical network preferred.
• Thorough knowledge and understanding of clinical integration and value-based care, including development of alternative delivery systems, clinical improvement processes and clinical information and data management systems.
• Demonstrated ability to interpret clinical and financial performance data to identify practice transformation opportunities.
• Knowledge of payor, regulatory and accreditation requirements; medical practice workflow; terminology and reimbursement policies.
• Experience planning, organizing, delegating; prioritizing among multiple demands/tasks, coordinating work activities across stakeholders, and evaluating effectiveness of improvement methods and procedures.
• Demonstrated experience communicating clearly and effectively, interacting, and working effectively with executives, staff, providers, and payors.

Additional Information

• Organization: Corporate Services
• Department: HF CIN
• Shift: Day Job
• Union Code: Not Applicable