Providence California Jobs

Job Information

Providence Health & Services GVP, Value Based Care in Irvine, California

Description:

THE ROLE

The GVP will lead Value Based Care in Southern California. Will have responsibility for the Clinically Integrated Network (CIN) and Health Provider Network (HPN) by engaging physicians and developing a comprehensive provider service network. The GVP, Value Based Care will oversee the integration of data, the establishment of clinical care pathways and the development of a high performing, outcomes-driven network. The GVP, Value Based Care/CIN-HPN will advise information system teams, direct clinical teams in the development of care pathways and lead the CIN Steering Team with the goal of bringing to the Southern California market, an effective and proven provider network with recognized outcomes.

The GVP, Value Based Care/CIN-HPN will be visible and engaging leader with an effective and open communication style. He/she will be experienced in data integration, quality measurement and outcomes performance. He/she will inspire physicians in the promotion of evidence-based guideless linked to quality and the appropriate use of resources. He/she will proactively identify creative, innovative and reliable approaches to enhance overall clinical quality and will demonstrate results. The GVP, Value Based Care/CIN-HPN will connect all stakeholders with a common vision and represent the CIN to health system leaders and potential partners.

The GVP, Value Based Care/CIN-HPN will partner with clinicians, information systems, hospital and regional leadership to enhance clinical integration and service excellence in a way that is consistent with the mission, vision, goals of St Joseph Heritage Health. The GVP, Value Based Care/CIN-HPN will work with the administrators and CEOs of St Joseph hospitals in decisions affecting the health's system's clinical programs.

Working closely with Medical Groups, affiliates, the MSO and the acute ministries, etc., the GVP, Value Based Care/CIN-HPN will be accountable for leading value based care in Southern California. This includes leading and accountability for the IDN meetings (medical group and Hospitals) for all ministries in Southern California.

ESSENTIAL FUNCTIONS

The GVP, Value Based Care/CIN-HPN will:

  • Optimize a diverse network of medical group and affiliate providers across St. Joseph Heritage Healthcare to improve healthcare quality and reduce unnecessary cost. Partners with Heritage Leadership to grow the network and align physicians with similar values who bring innovation and performance, and who enhance the network delivery through quality improvement and resource efficiencies.

  • Lead the development and adoption of cost effective clinical protocols for high cost/high utilization conditions across the network. Assists in the development of provider system-based disease management programs. Sets quality and disease management metrics and targets.

  • Provide medical leadership to ensure relevant data sources are connected to the HIE so quality reports can be generated in support of disease management metrics. Collaborate with HIE, analytics and quality teams to develop quality reports.

  • Partner with Medical Management leadership team to connect cost reduction innovations in specialty services to the CIN. Using tools and processes, evaluate the potential specialty services that demonstrate cost efficiency opportunities and establish a reporting system to track and report outcomes. Work with physician leaderships

  • Leverage the energy and innovation of local physician leaders and quality improvement champions to enhance outcomes. Engages with Physician Site Directors at the medical groups and Affiliate Quality Medical Directors to counsel physicians in the use of protocols and care pathways, and in the improvement of outcomes.

  • Collaborate with all appropriate boards, subcommittees, councils and departments and physician leaders. Assists the executive leadership in setting and articulating the CIN vision and gaining commitment of medical group and affiliate providers. Provides medical leadership to CIN steering team and assists in development of the overall CIN provider network strategy

  • Partner with the sales and employer strategy team to identify and define new and innovative strategies to achieve business goals and objectives.

  • Develop the CIN with all stakeholders involved: patients, providers, purchasers and payers. Understand the reporting needs and expected outcomes performance of government and private payer contracts including shared savings, bundled payments and capitation. Collaborate with quality, performance improvement, risk adjustment and other departments to enhance outcomes.

Qualifications:

IDEAL qualifications

Required experience/education for this position include:

  • Medical Doctor or Doctor of Osteopathic Medicine preferred.

  • Five years’ of leadership experience in a comparable panel management and/or population health role required.

  • Five years’ experience working with healthcare systems with a sizeable affiliated physician base or an independent physician association.

  • Ten years’ of accomplished network experience in a large, complex, and integrated healthcare or payer setting is preferred.

  • Six plus years’ experience working with healthcare systems with a sizeable affiliated physician base or an independent physician association is preferred.

  • Previous experience in developing and/or operating management service organizations is preferred.

  • Previous familiarity with various physician compensation plans, incentives and contracting arrangements is preferred.

  • Ability to assess the payer environment and oversee the development of the strategic plan for approaching payers to ensure value capture from plan design/ contracts.

  • Ability to review processes of care and identify gaps to fully migrate to population health management, if applicable.

  • Ability to review IT infrastructure and facilitate discussions regarding the necessary investments needed to set up an organization for an accountable care future.

  • Possess knowledge of NCQA, JCAHO and other regulatory agency requirements pertaining to delivery of health care in the ambulatory care setting.

  • Ability to lead a comprehensive assessment of a physician network to create an alignment plan - inclusive of all potential models (i.e. CI, employment, co-management, medical home development, IT deployment, MSO services, etc.)

  • Possess dynamic leadership skills with the ability to navigate a complex environment in order to achieve desired outcome.

  • Possess excellent verbal and written communication skills, including public speaking with the ability to present information in front of large sized groups of diversified backgrounds and experience.

  • Ability to effectively interact and establish immediate credibility and where appropriate consensus with all levels of management, physicians, staff, patients, and community leaders.

  • Must possess effective employee management skills.

  • Knowledge of ambulatory healthcare delivery, management and measurement.

  • Ability to adapt quickly to changing conditions while managing multiple priorities.

  • Excellent analytical, problem-solving, and organizational skills, including inspirational leadership style.

  • Detail-oriented with excellent follow up and follow through skills.

  • Treats all with whom contact is made in a values based respectful manner.

  • Must demonstrate professionalism and sensitivity to diverse cultural backgrounds at all times and in all situations.

  • Thorough working knowledge of Affiliated Physician Networks administrative-related activities.

  • Possess understanding of setting, leading and achieving outstanding clinical outcomes.

  • Must have insight and understanding as to the California Legislative issues both current and proposed that affect managed care.

  • Ability to travel between SJHH locations.

Preferred experience/education for this position include:

  • Active medical license.

We offer comprehensive, best-in-class benefits to our caregivers. For more information, visit

https://www.providenceiscalling.jobs/rewards-benefits/

Our Mission

As expressions of God’s healing love, witnessed through the ministry of Jesus, we are steadfast in serving all, especially those who are poor and vulnerable.

About Us

Providence is a comprehensive not-for-profit network of hospitals, care centers, health plans, physicians, clinics, home health care and services continuing a more than 100-year tradition of serving the poor and vulnerable. Providence is proud to be an Equal Opportunity Employer. Providence does not discriminate on the basis of race, color, gender, disability, veteran, military status, religion, age, creed, national origin, sexual identity or expression, sexual orientation, marital status, genetic information, or any other basis prohibited by local, state, or federal law.

Schedule: Full-time

Shift: Day

Job Category: Leadership

Location: California-Irvine

Req ID: 312379

DirectEmployers