AdventHealth President PHSO in Maitland, Florida
If you want to be a part of a place that provides nothing less than extraordinary compassionate care, then AdventHealth is the place for you!
As a faith-based organization, it is the intention of AdventHealth to identify and employ executive leaders who are professionally competent and who provide leadership that is consistent with our mission. It is required that the candidate serve the mission of Extending the Healing Ministry of Christ and demonstrate proficiency in the AdventHealth executive leadership competencies.
We are currently seeking qualified candidates for a President, Population Health Services Organization (PHSO)/ Chief of Population Health and Value-Based Care position located at our headquarters in Altamonte Springs, Florida. Reporting to the Chief Strategy Officer, the President - PHSO is responsible for the development, execution and growth of profitable risk-bearing business that engages and manages the total health needs of consumers.
GENERAL SUMMARY :
Using advanced population health processes, technology and expertise, the President-PHSO will lead AdventHealth in the development and deployment of healthcare products and services focused on whole-person care and designed to create the best health outcomes for its consumers. The President-PHSO is responsible for strategy implementation, planning, organization and direction of population health initiatives including business development, payor partnerships, contracting, management of AdventHealth’s PHSO and the development of distinct business lines organized around commercial and government payor types in support of value-based care.
PRINCIPAL DUTIES AND JOB RESPONSIBILITIES :
· Serves as the executive lead for population health program development providing strategic vision and direction to ensure innovative models of health care delivery, and full execution of population health strategies that lead to high quality, patient-centric health and service outcomes of eligible beneficiaries, including complex case management, disease management programs, health risk assessment, wellness and lifestyle management strategies, health education programs, outreach and other programs for specific populations.
· Leads organizational value-based care business development executives, designing and leading the implementation of new business models and strategic partnership opportunities.
· Oversees and finalizes the negotiation of risk contracts with new and existing payors and providers based on prior contract performance, future potential and thresholds and ensures compliance with established legal requirements.
· Deploys tools to monitor outcomes, specifically population health indicators such as patient activation, quality of life, disease-specific clinical outcomes and health risks; lines of business-specific utilization, financial trends and return on investment/cost/benefit analyses; population health analyses such as overall morbidity and disease patterns, overall social and environmental factors, and overall work productivity.
· In partnership with the Chief Clinical Officer(CCO), develops clinical quality improvement strategies, including the development and evaluation of the quality standards and monitors the provision of safe quality care to eligible beneficiaries through key performance indicators developed with the CCO to capture the performances of the contracted facilities using the broad categories of clinical excellence, patient and staff experience, population health status and prevalence studies/data, which shall be benchmarked against regional and national benchmarks.
· Directs the establishment and maintenance of internal communication and education processes that assure operations are conducted in compliance with contractual terms, and the establishment and maintenance of on-going tracking and reporting systems and methodologies, in order to measure and document contract performance.
· Anticipates which contracts will not be renewed through negotiations and effectively develops and implements strategies which minimize disruptions to patient care and relationships with patients, physicians, employers and brokers; and optimizes financial performance and market share.
· Collaborates with senior leaders who are accountable for driving population health / value-based care performance in AdventHealth markets.
· Represents the strategic value-based care interests of AdventHealth to internal and external stakeholders.
· Maintains relationships with related or affiliated physician organizations regarding value-based care activities, including, but not limited to, negotiation and implementation of risk sharing agreements, out-of-network contracting, communication, and operational coordination.
· Coordinates with information technology and other departments regarding the selection, implementation, utilization and maintenance selection of tools to facilitate risk bearing activities.
· Contributes to the elaboration and ensures proper data sharing policies and procedures, privacy and other regulatory policies and procedures.
KNOWLEDGE AND SKILLS REQUIRED :
· Comprehensive knowledge of value-based care and population health as well as previous experience in the commercial health care industry, self-funded health plans, and managed care industry.
· Strong knowledge of finance, cost control and budgeting. In-depth knowledge and understanding of the healthcare market, managed care, capitation and capitation management, and understanding of the relevant regulations. Advanced capitation and capitation management skills, including a working knowledge of actuarial analysis and risk evaluation methodologies necessary for designing reimbursement methods, calculation and evaluation of reimbursement rates, and forecasting effect on revenues and expenses.
· Experience optimizing health insurance plan premium revenues through risk adjustment and must have experience containing total cost of care / total medical expenditures while preserving or improving relevant quality measures. Cost containment experience must include utilization management, care management, disease management, health plan network optimization, and health plan contracting. Quality experience must include HEDIS, CAHPS, and Medicare Advantage Star Ratings.
· Experience working across payors and providers to leverage resources and to achieve shared goals with health outcomes and with financial outcomes. Candidate leadership experience of integrating strategies and initiatives between payors and providers may be under one system wholly owning and operating both payor and provider, or that candidate leadership experience may be within a private payor partnering with external providers unowned by the private payor.
· Understanding of legal and regulatory requirements relating to managed care risk and fee for service contracting, including the ability to exercise independent judgment in finalizing contract language.
· Exceptional leadership and people management skills including decision-making, team-building, motivation and conflict resolution
· Outstanding written and verbal communication skills. Able to effectively express ideas and views through public speaking, presentations, reports and professional correspondence
· Strong business acumen, intelligence, and capacity; able to think strategically and implement tactically.
· Approaches work as an interconnected system. Ability to understand major objectives and break them down into meaningful action steps.
· Strong organizational abilities and the flexibility to adjust to changing conditions and the various details of the position.
· Analytical and disciplined with a sense of urgency.
EDUCATION AND EXPERIENCE REQUIRED :
· A bachelor’s degree in business or health administration (Master’s degree preferred)
· Five (5) years of senior managerial experience (10 years’ management experience preferred)
· Leadership experience in a health plan or risk-bearing entity
If this position sounds like a great match for your skills set and experience, please apply online now!
This facility is an equal opportunity employer and complies with federal, state and local anti-discrimination laws, regulations and ordinances.
We are an equal opportunity employer and do not tolerate discrimination based on race, color, creed, religion, national origin, sex, marital status, age or disability/handicap with respect to recruitment, selection, placement, promotion, wages, benefits and other terms and conditions of employment.