The Vice President/General Manager of the MSO plans, organizes, directs, and controls the Managed Services Organization (MSO). Reporting to the COO, has oversight of the MSO operations and P&L ownership (e.g., general administrative, patient care, professional services and/or a combination of these and other services). Directs and oversees the daily operations of the MSO, as well as all functions related to provider contracting, provider education, utilization management, coding, quality management, network management, and case management.
Duties and Responsibilities:
- Responsible for the overall growth and success of the MSO across all functions either directly or through matrix-management
- Manages MSO P&L / Budget, regularly identifying growth and cost-savings opportunities, and develops business cases / project plans to execute on opportunities.
- Manages a team of clinical and administrative consultants to direct provider clinics in population health management to improve quality of care, patient satisfaction, and total cost of care.
- Works with Healthplan partners on growth and improvement initiatives
- Builds and cultivates relationships with new provider partner candidates.
- Determines and support’s the provider’s needs in order to reach their requisite financial performance.
- Holds regular Joint Operations Committee meetings with the MSO partners.
- Works with management and physicians to identify and establish programs and practices which will help drive cost effective and high-quality care for patients, staff, and physicians.
- Studies financial and utilization reports to identify opportunities for improvement and develops projects / programs to act on these opportunities.
- Demonstrates effective communication, by communication progress, challenges, and issues to both senior leadership and partner-providers.
- Conducts regular retro-evaluations on the effectiveness of implemented action plans based on review of financial and clinical performance.
- Contributes toward the overall development of programs and services to meet the needs of patients, physicians, and staff.
- Provides strategic leadership to ensure equitable distribution of resources and delivery of high quality, cost-effective health care and efficient management of staff in accordance with goals, objectives, policies, and applicable regulatory agency rules and regulation.
- Responsible for the day-to-day operations by facilitating the development, implementation and monitoring of service, quality, and utilization standards.
- Continually evaluating and improving the delivery of service by initiating and promoting best practice models
- Develops short- and long-term plans to improve the service level of department efficiency for each area managed.
- Directly and with the manager/supervisor, develops and administers appropriate policies, standards, practices, and procedures.
- Assures compliance with administrative, legal and regulatory requirements and government/ accrediting agencies.
Qualifications / Education / Licenses:
- 10+ years’ primary/ambulatory care environment, value-based care (VBC), health insurance, healthcare, health industry, population health management, or related field in a leadership position
- Bachelor’s Degree Healthcare Administration, Public Health, Business Administration or related field, or equivalent work experience
- Understands, in detail, the daily, weekly, monthly and yearly metrics of the MSO and is able to make adjustments to hit predefined goals/objectives
- Excellent verbal, written, interpersonal and communication skills with the ability to make presentations to various groups of the organization(s) including presentations to the Leadership Team
- Ability to build strong relationships with health plans and providers.
At Clinical Care Medical Centers, we are committed to providing an environment of mutual respect where equal employment opportunities are available to all applicants and employees without regard to race, color, religion, sex, pregnancy, national origin, age, physical and mental disability, marital status, sexual orientation, gender identity, gender expression, military and veteran status, and any other characteristic protected by applicable law. Clinical Care Medical Centers believes that diversity and inclusion among our employees is critical to our success as a company. We support an inclusive workplace where employees excel based on personal merit, qualifications, experience, ability, and job performance.
