The objective of this position is to provide administrative leadership for Managed Care and Quality Management departments. Priorities include optimization of financial performance of the LLUH provider network, with an emphasis on dual-risk Medicare Advantage contracts; and enhancement of performance on value-based reporting for at-risk programs (e.g. capitated commercial and dual-risk Medicare Advantage health plans, ACO-CMS/Medicare populations). Scope of responsibility includes strategic planning, financial analytics, compliance with contractual and regulatory requirements, financial reporting on dual-risk Medicare Advantage to LLUH and LLUFMG executive leadership. Promotes growth in business opportunities through professional relationships in the community and region. Establishes a data-driven environment with integration of performance improvement processes. Collaborates with and supports VP of Clinical Efficiency and Managed Care with necessary analytics to evaluate performance. A collaborative relationship with LLUFMG executive leadership, VP of Clinical Effectiveness and Managed Care, Contracting, and LLUH executive leadership is essential to the success of managing this at risk population, and placing LLUHC as a benchmark for best practices. Other duties as assigned.
|