Chief Network Officer
Location Miami, Florida, United States of America Category Corporate Job Id R0015725
ChenMed is transforming healthcare for seniors. We provide big answers to big problems in health care delivery. ChenMed is a full-risk primary care market leader with an innovative philosophy, unique physician culture and end-to-end customized technology. These things allow us to provide world-class primary care and coordinated care to the most vulnerable population – moderate- to low-income seniors who have complex chronic diseases.
Through our innovative operating model, physician-led culture and empowering technology, we are able to drive key quality and cost outcomes that create value for patients, physicians and the overall health system. Our model allows us to practice medicine the way it should be practiced. By recruiting focused physicians and reducing their doctor-to-patient ratios, we increase patients’ “face time” during each monthly appointment and help foster stronger doctor-patient relationships. Our model also drives and enhances compliance with treatment plans.
As a result of our efforts, our patients realize lower hospital admissions. Their overwhelming response to our approach is reflected in our aggressive, organic growth and net promoter scores in the low to mid 90s, which is unheard of in any industry. Read more about our results and the value of the ChenMed model.
As a company, we are making a difference in the lives of seniors and the health care system overall.
ESSENTIAL JOB DUTIES/RESPONSIBILITIES:
- Establishes vision, goals, objectives and performance expectations for the Network COE that are consistent with, and lead to the achievement of, corporate goals and objectives.
- Ensures maximization of value and cost effectiveness through collaborative relationships with high-quality and value-based specialists, hospitals and facilities across the markets they serve.
- Identifies and advances partnership opportunities, keeping executive leadership informed of competitive approaches.
- Uses data to establish key performance metrics to drive results, while maintaining relationships amongst colleagues and others within the organization.
- Partners closely with the Chief Clinical Network Officer to manage the overall network function within the company.
- Works with internal subject matter leads and executive leadership, including compliance and marketing COEs, to ensure consistency and coordinated engagement with the provider community.
- Assures effective management and integration of network functions, i.e., network development, provider information and reporting, provider relations, medical management, and related functions.
- Conducts routine, proactive and meaningful interactions with finance, clinical COE, operations and sales to ensure a competitive network is in place, and optimal terms and/or provisions are negotiated into contract development/updates and implemented as intended.
- Assists in the development of additional population-based contracts for the system, seeking to enhance physician alignment through designing programs and initiatives unique to ChenMed, positioning network and product offerings to maximize value-based care.
- Assures the development, implementation and maintenance of operating policies and procedures within the Network COE that maximize productivity, fulfill quality standards, and comply with all applicable laws, rules and regulations.
- Ensures timely preparation of operating and capital budgets for the Network COE and assures optimal use of resources to achieve corporate goals.
- Manages budgeting and forecasting initiatives on networks costs and provider contracts.
- Represents the company on appropriate local, state and national trade groups, government/industry workgroups and committees, and similar external venues.
- Helps lead development of high-value network products, including exclusive Medicare Advantage product offerings with specific payor partners.
- Assures that network operations have adequate human, financial and technological resources to function effectively and efficiently. In so doing, analyzes, negotiates and recommends acquisition of appropriate technologies, systems, equipment and vendor services.
- Shares responsibility for, and contributes to, policy formulation, strategic direction, priority-setting, decision making, achievement of corporate goals, and overall leadership of the organization.
- Supervises COE staff while providing leadership and growth of staff through planned development and coaching.
- Performs other duties as assigned and modified at manager’s discretion.
Performance Management and Leadership
- Establishes guidelines, expectations and standard models for Regional Network Directors (RNDs) that apply across all ChenMed, et al markets.
- Mentors, manages, onboards and develops Regional NDs.
- Supports Regional NDs in obtaining top level performance to meet and/or exceed financial plan targets for clinical claim cost.
- Provides performance feedback on the Regional NDs to Network COE and Market executives.
- Travels between markets to problem solve and collaborate with regional and market NDs to determine opportunities for performance and process improvement, network quality measures and value-add possibilities.
- Holds Regional NDs accountable for market progress against annual targets and plans, gives direction and guidance, when necessary.
- Works with Regional NDs and the Referral COE to intervene in underperforming markets.
- Assists the Chief Operating Officer and Chief Medical Officer in evaluating the performance of region and market NDs.
Strategy and Best Practices
- Collaborates with CSE to organize and chair weekly market ND conference calls to share and develop best practices.
- Convenes quarterly or similar regional and/or market ND meetings for training, discussion and performance management.
- Develops new tools, strategies and approaches to improve patient access to our centers, such as urgent transport, telephone consults, video consults and remote monitoring.
- Supports market NDs in implementing and refining new contracting arrangements.
- Codifies and promotes best practices identified across different markets.
- Provides project-based support to market NDs on designing and implementing service innovations. Works with NDs to codify modernizations and execute effective changes to markets as appropriate.
- Develops new tools and strategies for network management, such as improved insight into claims data and tools to strengthen and manage relationships with network partners.
- Researches and develops ways to improve comparisons and understand cost drivers within and between markets.
Relationship Building and Network Collaboration
- Builds relationships with payer staff that support and collaborate with network (e.g., Humana referrals approval team).
- Supports Regional NDs in their interaction with payers.
- Works with payers to improve richness and availability of data available to support network performance.
Liaison between Executive team, COEs and Markets
- Collaborates with CSE and BI to improve data insight available to market NDs.
- Works in partnership with the Referrals COE to improve support, processes and execution of referrals.
- Uses expertise and role to advocate on behalf of markets in company-wide collaborations, strategy development or problem solving.
- Facilitates interactions with supporting COEs and markets as required to drive forward market performance (e.g., BI, CSE, IT).
At ChenMed, If you are an innovative, entrepreneurial minded, over-achiever who is extremely passionate in helping people and revolutionizing Healthcare again, we are that dynamic and exciting company you are looking for!
After applying, we encourage you to "follow" us on LinkedIn (ChenMed) as well! This way you can stay informed and up to date on what’s happening around our organization and start your path to becoming part of our FAMILY!
KNOWLEDGE, SKILLS AND ABILITIES:
- High business acumen and acuity
- Results-oriented with high level of personal accountability, high energy and strong drive to develop him/herself while improving our business model
- Demonstrated ability to communicate effectively and openly with members at all levels
- Skillful in coaching and teaching management and leadership qualities
- Ability to realize great ideas through others and understand our internal business culture
- Ability to adapt to situations either as a slow consensus builder or a powerful motivator
- Understanding of fundamental economics of healthcare and network costs; understanding of value-based care, the healthcare landscape and strategic implications of competitor, partner, and regulatory activity
- Extensive knowledge of managed care structures and operations, including the interconnectivity of diverse and complex functions
- Excellent written and verbal communications skills with the ability to present to Senior Executives and/or Board Members
- Working knowledge of each of the functions that are intrinsic to network management, including knowledge of the technologies needed to function effectively
- Strong analytical and critical thinking/problem solving skills, with the ability to refine, summarize, and clearly present data and information to all levels of the organization
- Exceptional learning agility and servant mindset
- Proficient in Microsoft Office Suite products including Word, Excel, PowerPoint and Outlook, plus a variety of other job-related software
- Ability and willingness to travel locally, regionally and nationwide up to 50% of the time
- Spoken and written fluency in English
- This job requires use and exercise of independent judgment
EDUCATION AND EXPERIENCE CRITERIA:
- Bachelor’s degree in Business Administration or a related field required; experience may substitute for education on a year for year basis above the minimum required
- Master’s degree preferred; MBA highly desired
- Minimum of ten (10) years of relevant professional experience, preferably in a managed care plan or health care related enterprise; experience to include:
- Leadership - demonstrated success in growth and/or business development is required
- Interacting with hospitals; managing large teams and operational processes a plus
- Working with payors, preference toward candidates who have experience contracting with multiple payors and providers
- Designing and negotiating contracts and performance agreements; Profit & Loss desirable
- Analyzing and using data as core part of role, including use of sophisticated business intelligence tools required
- Building successful and collaborative relationships with specialist providers, facilities and hospitals desirable
The Chief Network Officer (CNO), in partnership with the Chief Clinical Network Officer (CCNO), is directly responsible for developing, implementing, and leading a strategic approach to building and sustaining a robust provider network that supports the ChenMed PCP-Led core model. The CNO engages executive leadership in driving and prioritizing proactive network initiatives that support key business objectives and drive business development opportunities. This position assures effective integration and efficient operation of the company’s provider network functions and ensures strong collaborative relationships across the health plan to guarantee a compliant, cost efficient and responsive provider network that supports service excellence. The CNO will be responsible for training, developing, coaching all network and business leaders while directly managing the Regional Network Directors. The incumbent in this role will provide continuous support to the regions to maintain alignment throughout the organizational process. The goal for Regional Network Directors is to ensure maximization of value and cost effectiveness through collaborative relationships with high-quality and value-based specialists, hospitals and facilities across the markets they serve. He/She will be responsible for properly documenting all training, development, coaching and management materials so that the fundamental knowledge base of the Network COE can grow, and knowledge is consistently shared with the markets’ Network Directors.
Get notified for similar jobs
Sign up to receive job alerts
Enter Email address (Required)