Job Description

Steward Health Care Network (SHCN) takes pride in its community-based care model, which drives value-added tools and services to our communities, patients, physicians, and hospitals across the continuum of care. In addition, Steward Health Care Network promotes care coordination and collaboration within the network in order to provide high-quality, efficient care to patients. With Steward in the community, all residents can be sure that there is a world class doctor close to where they live.

The network is also responsible for the implementation and execution of our managed care contracts, medical management services, quality improvement programs, data analysis, and information services.

Position Purpose:

The Vice President, Clinical Operations will set and lead the Clinical Operations and Integration Strategy and implementation plan for the MSO. This includes oversight and operations of clinical care management, behavioral health, and social determinants of health programs.

Responsibilities:

  • Responsible for directing Clinical Operations supporting a system-wide Clinically Integrated Network (Business Units, Analytics, IT, Performance Teams and practice/ hospital facing initiatives) and facilitating cross-business unit collaboration to scale Clinical Operations nationally, in support of growth in all regions, including international markets.
  • Responsible for advancing Steward’s strategic vision driving performance in a value based care model across multiple revenue streams.
  • Work effectively and closely with multiple enterprise teams including but not limited to the Business Units, Analytics, IT, Performance Teams and Human Resources when developing both short and long term strategies to drive performance.
  • Responsible for the management of clinical operations budgets
  • Oversee a staff of leaders to develop best in class programs in key subject matter areas to drive the national strategy & implementation plan. These staff will have direct oversight of managers and supervisors who are responsible for driving performance and achieving budget targets
  • Drive operational excellence across all Clinical Programs by ensuring Key Performance Indicators are met to meet budget targets
  • Oversees population health management across SHCN’s Clinical Programs and participates in shaping Steward’s overall system strategy driving the highest cost efficient and quality care in the industry
  • Effectively collaborate and inspire highly functioning teams within a complex, fast paced, matrixed organization to shape innovative organizational strategies for driving performance
  • Ensure that the clinical operations team clearly understands and is working towards supporting the overall strategic imperatives driving performance for their program as well as the organization as a whole.
  • Works closely with the Local Chapter Performance Team and Performance team to communicate medical best practices and guidelines to SHCN providers in support of our quality program and contractual obligations.
  • Ensure medical management program activities are performed in a cost effective, productive, and timely manner.
  • Develop plans, systems, and methodologies to implement policies approved by the SHCN Regional Board.
  • Play a key role as a liaison between SHCN, Steward and non-Steward Hospitals, post-acute care facilities, home care, community partners and any other organization which SHCN patients may seek care to optimize transition of care.
  • Ensure the clinical operations leadership team acts as an internal consultant to other population health staff as clinical subject matter experts
  • Collaborate with Case Management, Referral Management, and other program directors and managers to ensure that adequate support is provided by the Network and that members, providers, hospitals, and others who transact business with SHCN staff are provided with effective, efficient, and courteous service at all times.
  • Review audits, utilization reports, and patterns of practice and makes recommendations to correct problems identified including chart reviews for the purpose of coding education.
  • Attends meetings with payers and other third party organizations as needed.
  • Assists in the resolution provider grievances and other clinical provider service issues.
  • Performs other functions as assigned.

Education / Experience / Other Requirements

Education:

  • Board Certified Physician or other Licensed and Certified Provider such as Nurse Practitioner or Physician Assistant; Primary Care Specialty preferred but not necessary. Current Licensure Required

Years of Experience:

  • Minimum of 10 years of experience in the health care industry in a leadership role

Specialized Knowledge/Skills:

  • Experience in health care management and process improvement skills (LEAN, Six Sigma, or equivalent) preferred.
  • Advanced ability to analyze cost and clinical care outcomes across a variety of care settings
  • Strong knowledge of care management and care coordination
  • Proficiency in computer and technology utilization required, including, but not limited to: care management software, Microsoft Office Products (Outlook, Excel, Power Point, Word, Visio)

Abilities:

  • Possess strong clinical background in care management, ambulatory and post-acute care settings with focus on the delivery of high quality and cost effective care.
  • Demonstrated expertise in strategic thinking and the ability to create design and implement successful programs
  • Possess strong interpersonal written and oral skills.
  • Possess and demonstrates excellent time management skills with proven ability to effectively manage multiple tasks and priorities at one time.
  • Demonstrates advanced knowledge of managed care concepts such as Risk Based Contracting, Care Coordinate, Care Management, Transitions of Care, Tele-monitoring
  • Ability to collaborate with multiple providers to provide quality and cost effective care for risk members.
  • Requisite poise, judgment, and trustworthiness to represent SHCN to internal and external groups.
  • Maintains information in a confidential manner according to policy and legal requirements

Travel:

  • Up to 20% national travel is required for this role

Application Instructions

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