Schedule: Regular Full-time
Hours: 8:00 am - 4:30 pm
The VP, Operations for Beacon Health, LLC is a highly visible and strategically important role at the center of population-based health care and payment reform efforts for Northern Light Health. The VP, Operations is a central figure, leading Beacon Health's operational functions delivered jointly by resources from Beacon Health and Beacon Direct. The role also includes significant participation in developing and implementing the Beacon Health strategy and executive level stakeholder communication to ensure organization goals are met or exceeded.
The VP, Operations is responsible for delivering efficient services that meet the needs of patients, physicians/providers, the community and staff. This will either be done directly, or through delegation of responsibility to the management team.
The VP, Operations will lead performance improvement efforts by leveraging health information technology and analytics in clinical quality, network integrity, clinical transformation and care management.
The VP, Operations role requires significant leadership skill, ability and is seen as a change agent to ensure that performance improvement and operational objectives are achieved. The VP, Operations will work with the Beacon Health members and strategic partners to guide transformation efforts from volume-based reimbursement to a value-based model of care. This will require strong working relationships with Executive Leadership across Northern Light Health member organizations and Beacon Health contracted facilities and provider groups. The VP, Operations will participate in Northern Light Health population health and system/practice transformation initiatives to ensure the success of Beacon Health and the consistency, integration and alignment of operational practices of Beacon Health with system strategies.
The VP, Operations is responsible for providing oversight and guidance around departmental functions such as operational planning, vendor relationship management, budgeting and in collaboration with the VP of Finance and President of Beacon Health, financial forecasting and population health contract evaluation. In addition, the VP will participate in population health contract negotiations and direct to employer discussions. The VP, Operations is responsible for ensuring that services are in compliance with federal, state, funding, certifications, and licensing requirements. Finally, the VP, Operations will assist the President in planning and organizing.
The VP, Operations is responsible for ensuring legal compliance required under the law and to which the Board of Trustees expects all members, partners, participants, participant employees, managers and contractors to adhere. The VP, Operations will work closely with the Compliance & Privacy Officer to ensure principles of Compliance Program are followed.
Reports to: President, Beacon Health.
Develop and execute strategic plans for Beacon Health that ensures the connection with the Northern Light Health (NLH) strategic plan. Contributes to business plan development and implementation collaboratively with Beacon Health leadership team.
Utilizing matrix management directs and/or coordinates staff throughout the organization in the implementation of strategic work plans or other initiatives for Beacon Health, LLC operations including but not limited to: CMS, MSSP ACO, NLH Employee Health Plan, Maine care, employer and commercial payers program initiatives and maintenance and improvement activities.
Management of a team of professionals under direct supervision including functional areas of Information Technology, Operations, Data Analytics and Program Management.
Lead effective network patterns committee/initiative across Northern Light Health for best clinical and financial results under value-based care model. This includes establishing annual system goals.
Oversee all communication activities materials/publications relating to Beacon Health, LLC.
Works closely with legal resources to address fraud, abuse and compliance.
Responsible for coordinating all business operations, including, coordination with and oversight of delegated Business Operations Support staff.
Ensure contract deliverables (population health, network patterns, wellness, etc.) are met or exceeded and services are provided as efficiently and effectively as possible.
Collaborates with staff from across the Beacon Health to research specific issues as necessary to develop and analyze solutions and make policy or programmatic recommendations to address operational issues.
Direct and/or coordinate with staff from all departments and disciplines in support of Beacon Health, LLC lines of business and its members.
Coordinates the work of consultants engaged in performance improvement and assists them in implementation of recommendations.
Works with department managers as a mentor, educator and counselor to foster change and assist them in the implementation of recommendations.
Active involvement in risk-based payer contracting and negotiations by meeting with payers, employers and other executives.
Oversees the CMS MSSP ACO regulatory affairs function and ensures implementation to the program changes to comply with these regulatory requirements and is responsible for communication to stakeholders.
In conjunction with the Director of Compliance, ensures that Beacon Health conducts its activities in compliance with all federal, state and local laws and regulations and in conformance with the highest standards of business integrity.
Serves as the authorizing official for CMS information as it relates to the Federal Information Security Management Act (FISMA).
Coordinates data mining and data analysis activities for contracting and quality improvement activities.
Ensures appropriate communication about Beacon Health, LLC's operational issues and ensures adherence to work plans, identifies problem areas, develops solutions to issues or problems, conducts strategic plans and ensures that all departments are adhering to the short- and long-term objectives for the health plan and it diverse lines of business.
Works closely with the Senior Physician Executive, Population Health as a functional management dyad.
Create, review and recommends for approval, policies and procedures.
Oversee the preparation of concise and clear reports for submission to CMS, Board of Directors, Board of Managers, executive management or others, as required.
Minimum Education Required
Must possess a Bachelor's degree in Business Administration or related field from an accredited Institution.
Masters of Business Administration or Healthcare Administration highly preferred.
At least 10-12 years' experience working with health care delivery system including significant experience in managing primary care/practice operations. At least 3 years' experience in a director level position managing a significant number of practices and employees. Position requires experience in one or more of the following areas: public or private insurance/health plans, provider-side managed care, or health care provider operational/clinical leadership.
Knowledge, Skills and Abilities
Demonstrated leadership in situations involving complex, large-scale change. Skill and understanding of how to achieve results. Well-developed planning, marketing, organizational development, and business skills. The ability to work with physicians/providers, staff and professionals in multiple settings and locations and promote diversity in the workplace. Information systems capabilities and an appreciation for the data which will be required to make meaningful management decisions. Negotiation as well as financial analysis skills.
Equal Opportunity Employment