Executive Director

Executive Director –
Hartford, Ct –

We have been engaged by a large national health insurer, a family of companies specializing in providing high risk patients with a complete and proactive health care experience.  This organization is entering a new growth phase, as a proven care delivery model for high-risk patients.  We are assisting in the search for an Executive Director for the Connecticut Market for a subsidiary organization.

This subsidiary is a is an integrated health plan and care delivery system for Medicare and Medicaid patients. The team of committed clinicians and business leaders passionate about transforming American healthcare delivery.  They build and lead health plans and clinical teams to care for the most complex patients, serving over 100,000 patients in seven states across Medicare, Medicaid, and soon, commercial populations.  Striving for excellence and achieving significant and measurable improvement in total cost of care, clinical outcomes, and experience.

As a subsidiary, you benefit from the scale and resources one of America’s largest managed healthcare organizations. Service areas will include New Haven and Hartford counties, and additional markets may be added as continues to grow.

The market Executive Operations Director reports to Chief Medical Officer, Primary Care and Collaboration division, and is responsible for:

  • leading local market operations to successfully deliver on patient engagement, health outcomes, and financial goals.
  • direct strategy and operations for all business activities within Connecticut to help launch, sustain, and grow field-based care delivery model.
  • partner with Regional Medical Officer, who holds accountability for clinical results market-wide.
  • management responsibility for Case Management and Clinical Partner staff, and be responsible for successful hiring, retention, staff development, and performance management.
  • Care delivery objectives focus on meeting key health improvement metrics, achieving patient engagement targets, partnering successfully with the provider community, and creating a strong foundation for clinical operations.
  • The successful candidate will leverage knowledge across partner BUs (including Primary Care and Collaborations Division, as well as Health Plan “Classic” Division), to develop and replicate leading clinical results in Medicare Advantage and Medicaid.
  • building and sustaining positive relationships with healthcare professionals and other stakeholders, including local IPAs, ancillary care providers, and payor partners.

 

Requirements:

  • Core Competencies:
    • Hands-on clinical operations leadership experience (including team leadership and development;
    • patient and community engagement;
    • field-based practice operations, among other functions), preferably managing in the primary care / outpatient setting, or in the home-based setting
    • Experience administering budgets for clinical models, including capitated and / or value-based payment models
    • Strong belief in and passion for clinical model and care philosophy
    • Ability to work in an agile “start-up” environment, including the ability to lead within ambiguous settings;
    • strong team-building and presence; internal motivation and drive;
    • track record of delivering results
    • Ability to drive work independently while partnering across multiple stakeholders, including clinicians and business leaders internally and externally
    • Aptitude for strategic thinking with the ability to identify, leverage, and spread best practice while demonstrating a continuous innovation mindset
    • Ability to forge strong relationships with physicians and other healthcare leaders, and identify new opportunities to support continued expansion
    • Strong communications and executive presence
    • Knowledge of the local CT healthcare market preferred
    • Experience managing complex populations and Medicare Advantage populations preferred

Work location: New Haven and Hartford Counties, CT (60% Field-Based and 40% Office Estimated) Position requires some travel to leverage best practice from existing markets, and support new growth activities.

Essential Duties and Responsibilities

  • Guide clinical operations and successful collaboration with payors and providers to facilitate the success of home-based model of care within the region to achieve clinical, operational and financial success
  • Provide thought leadership in developing and implementing care continuity plans and tactics as members transition into the model
  • Lead and guide a team of clinical partners and case manager staff (~8 in year 1) to maximum performance
  • Lead provider network collaboration strategies, including guiding provider implementation and partnerships to facilitate gaining support of the model
  • Direct local leadership teams to establish, implement and maintain community outreach and resource strategies that establish program acceptance, positive public relations and critical partnerships
  • Direct local leadership to establish, implement and maintain member/patient retention strategies to ensure that growth and retention goals are met
  • Lead location business development and innovation efforts that grow reach within the Connecticut service area
  • Oversee all operational activities and resource efficiency within the local markets
  • Partner with regional and local market clinical leaders to exceed clinical outcomes goals that live up to standards, as well as to deliver Medicare Advantage goals commensurate with CMS HEDIS and Quality expectations
  • Partner cross-functionally and with peers across the organization to provide new market operational support and infrastructure (E.g., IT; Finance & Accounting; Reporting & Analytics; Quality)
  • Analyze financial and operational data to uncover performance issues and leading the execution of improvement opportunities
  • Prepare background analysis and external project documents required to support business development process with collaboration partners
  • Contribute analyses and presentations as inputs to executive-level materials in support of regular business planning cycle, Joint Operations Committee meetings, and executive leadership updates
  • Provide leadership in building a culture of teamwork with peers and indirect reports
  • Collaborate with internal colleagues and external business partners effectively using professional maturity and sound business judgment

Minimum Qualifications Education and/or experience:

  • bachelor’s degree (BA or BS) from a four-year college or university;
  • master’s degree (MBA, MHA, MPH) preferred;
  • over ten years of related experience and/or training; or, equivalent combination of education and experience.
  • at least ten years of experience in the field;
  • demonstration of expertise in a variety of the field’s concepts, practices, and procedures.

 

Exceptional opportunity with dynamic organization – competitive salary and relo assistance and exceptional career growth potential

 

If you are personally interested in learning more about this position and wish to have a confidential conversation, please submit resume with salary history:

Pat Holtermann at 360-665-2433 ~ 888-778-0098 or Send resume to pat@hva-jobs.com