Henry Ford Health System 117610 - VP- Network Management in Troy, Michigan
The Vice President, Provider Network Management (VP, NM), in concert with and under the direction of the Chief Financial Officer (CFO) will be responsible for providing senior level leadership, guidance and oversight over all network management including: Provider Contracting, Strategic Relationships, Regional Contracting and Plan Management. The position will develop, lead and align the execution of both short term tactical initiatives and long term strategies which will facilitate the organization’s ability to meet or exceed annual medical cost budgets. The VP, NM will provide oversight of major corporate-wide medical and provider oriented projects/initiatives. In partnership with the Chief Financial Officer and the organization’s senior and associate medical directors, the VP, NM will integrate provider network plans, activities, programs, policies and initiatives throughout the company to meet corporate objectives. The VP, NM will exhibit insight, innovation and leadership to drive multiple strategies which will result in effectively managing medical benefit costs while continuously improving quality, access and customer satisfaction.
In partnership with the Chief Financial Officer, leads the development and implementation of all provider network management strategies and programs.
Leads the functions in Provider Network Management and Provider Contracting.
In partnership with the Chief Financial Officer and medical directors, provides strong leadership in implementing initiatives and strategies to control medical costs to achieve budgeted medical cost targets. This should occur through support of state-of-the-art provider contracts which incorporate the principles of performance accountability, effective medical management strategies, use of health information technology systems and implementation of a process of continuous improvement in care delivery.
Oversees the development and implementation of provider contracting strategies and provider contracting negotiations and ensures the terms of the contracts are fulfilled.
Develops and implements a set of strategies to guide provider contracting and servicing activities for business expansion. Develops and implements strategies to strengthen and/or develop new physician, hospital and other provider relations. Defines provider network expansion requirements in new and existing geographic service areas.
Incorporates new, innovative, emerging and/or effective quality and benefit cost control programs to improve the delivery of high quality and cost effective care for the organization’s membership.
In concert with developing collegial and mutually beneficial relationships, provides insight and information to Henry Ford Health System physician and administrative executives relative to provider contracting activities.
Directs assessment and changes to utilization and medical management business rules and processes in a manner that optimizes the effectiveness and efficiency of network operations and the delivery of clinical care.
Collaborates with Henry Ford Health System (HFHS) leadership on key objectives and system-wide programs. Effectively represents HAP’s interests and relationships with the Henry Ford Medical Group, HFHS provider operations, and other providers of services to HAP members.
In partnership with the Chief Financial Officer, reviews, revises and directs departmental budgets for assigned areas and develops a broad based organizational budget strategy, incorporating both long and short-term corporate objectives. Focuses on cost management initiatives and programs to improve financial performance.
Collaborates with Human Resources to develop and complete an assessment of staff core competencies as part of an effort to attract, retain and develop top talent. Develops an ongoing plan to fill skill gaps, including but not limited to training, cross training, reassigning roles, employee engagement scores, etc. for personal development. Establishes annual employee performance goals and developmental plans for all direct reports and their respective teams. Monitors progress on a quarterly basis to assess the level of employee morale and productivity and developing corrective action plans as indicated.
Education: Minimum Bachelor’s degree in Business Administration, Healthcare Administration or related field with a relevant advanced degree (MHA or MBA) preferred.
At least 10 years of relevant health plan experience; with demonstrated competency in strategy development, negotiations, execution and implementation of contracts.
Minimum five (5) years of relevant management experience.
Demonstrated or equivalent experience in developing and managing networks to support comprehensive health insurance products.
Demonstrated financial acumen and experience using medical costand other data and information as the basis for making sound decisions in contracting, as well as in the delivery of medical management, quality management and related improvement programs.
Experience working closely and effectively with physicians, hospitals, and other healthcare providers, with a preference for experience in integrated delivery systems.
Proven leader with a demonstrated ability to lead and influence the direction of large scale enterprises.
A strong leader with proven ability to identify the need for change, anticipating, recognizing and creatively addressing resistance to change; working with others to view change as a challenge and opportunity for growth.
Complete understanding of Medical Loss Ratio (MLR) cost drivers and a demonstrated success in managing the medical cost component of the MLR.
Demonstrated or equivalent experience in leading all aspects of provider network activities, including network development, provider contracting strategies and negotiations, and provider servicing and relations which will facilitate the creation and maintenance of a high performing, accountable and engaged provider network.
Strategic influencer who drives agreement through intellect, interpersonal and negotiation skills.
Proven ability to attract, build, mentor and direct a high-performing cohesive and well-integrated team.
Understanding of the business environment and community, as well as trends and issues which will, or could potentially, influence the organization’s business performance.CRITICAL LEADERSHIP COMPETENCIES:
Customer-centric- Looks at problems through the lens of the customer, (both internally and externally), showing empathy and understanding in creating the best solutions.
Commitment to High Reliability- Preoccupation with failure; competence in performance improvement to identify errors for correction while at the same time innovating solutions; messaging to mission; leading safe operations and local learning systems.
Sense of Ownership- Demonstrates accountability for one's own responsibilities. Engages and empowers employees to do the same.
Principled– Self-aware, authentic and trustworthy; demonstrates sincerity and honesty in relationships and a relentless spirit to do the right thing for our customers each and every time.
Innovative –Ability to find creative solutions to challenges; entrepreneurial; navigating ambiguity and uncertainty by pro-actively disrupting traditional thinking when new ideas are needed.
Collaborative –Fosters teamwork across verticals to break down silos; demonstrates excellent communication skills with staff, peers and customers.
Results-Driven –Shows business acumen beyond areas of functional areas of expertise and a bias for action in accomplishing key objectives to help the organization thrive. Even when faced with multiple challenges, demonstrates resilience and swift problem-solving.
Data-based Decision Making –Synthesizes and uses data to improve performance with a focus on safety, customer experience and value.
Change Champion –Shows ease, agility and the ability to influence without formal authority, in driving change necessary to become a highly reliable organization and fulfilling all aspects of our True North framework.
Under the leadership of President and CEO Wright L. Lassiter, III, Henry Ford Health System is a
$6 billion integrated health system comprised of six hospitals, a health plan, and 250+ sites
including medical centers, walk-in and urgent care clinics, pharmacy, eye care facilities and
other healthcare retail. Established in 1915 by auto industry pioneer Henry Ford, the health system
now has 32,000 employees and remains home to the 1,900-member Henry Ford Medical Group, one
of the nation’s oldest physician groups. An additional 2,200 physicians are also affiliated with the
health system through the Henry Ford Physician Network. Henry Ford is also one of the region’s
major academic medical centers, receiving between $90-$100 million in annual research funding and
remaining Michigan’s fourth largest NIH-funded institution. Also an active participant in medical
education and training, the health system has trained nearly 40% of physicians currently practicing
in the state and also provides education and training for other health professionals including nurses,
pharmacists, radiology and respiratory technicians. visitHenryFord.com.
Whether it's offering a new medical option, helping you make healthier lifestyle choices or
making the employee enrollment selection experience easier, it's all about choice. Henry
Ford Health System has a new approach for its employee benefits program - My Choice
Rewards. My Choice Rewards is a program as diverse as the people it serves. There are
dozens of options for all of our employees including compensation, benefits, work/life balance
and learning - options that enhance your career and add value to your personal life. As an
employee you are provided access to Retirement Programs, an Employee Assistance Program
(Henry Ford Enhanced), Tuition Reimbursement, Paid Time Off, Employee Health and Wellness, and a whole host of other benefits and services. Employee's classified as contingent status are not eligible for benefits.
Equal Employment Opportunity/Affirmative Action EmployerEqual Employment Opportunity / Affirmative Action Employer Henry Ford Health System is committed to the hiring, advancement and fair treatment of all individuals without regard to race, color, creed, religion, age, sex, national origin, disability, veteran status, size, height, weight, marital status, family status, gender identity, sexual orientation, and genetic information, or any other protected status in accordance with applicable federal and state laws.