As a part of the Tenet and Catholic Health Initiatives family, Conifer Health brings 30 years of healthcare industry expertise to clients in more than 135 local regions nationwide. We help our clients strengthen their financial and clinical performance, serve their communities and succeed at the business of healthcare. Conifer Health helps organizations transition from volume to value-based care, enhance the consumer and patient healthcare experience and improve quality, cost and access to healthcare. Are you ready to be part of our solutions? Welcome to the company that gives you the resources and incentives to redefine healthcare services, with a competitive benefits package and leadership to take your career to the next step!

JOB SUMMARY

The Vice President of Operations provides leadership and management of Conifer Value-Based Care�s (VBC) health plan operations. The Vice President of Operations maintains relationships with clients and provides strategic partnership in their business in concert with other Conifer VBC executives. This position is responsible for the maintaining and enhancing performance of end-to-end health plan functions including but not limited to eligility, claims, call center, and data management. The individual will develop and execute on strategies to support Conifer VBC and client growth through enhancement of current services and development of new services. The VP of Operations establishes an organization culture consistent with Conifer�s values while fostering organizational change and a passion for continuous improvement.

ESSENTIAL DUTIES AND RESPONSIBILITIES

• Accountable for results and performance of health plan operations (eligibility, call center, claims, data management) at or above industry standards. Collaborates with medical management, network management, regulatory performance, analytics, and information technology to meet contractual client and regulatory requirements.
• In partnership with other Conifer VBC leadership, builds and maintains client and industry relationships through regular participation in client and health plan Joint Operating Committee meetings. Represents operational expertise and processes to prospects, as required.
• Develops and implements strategies to achieve organizational strategic vision and improve performance. Oversees selection, implementation, and management of key administrative platforms.
• Provides leadership, mentoring and management to team members to ensure goal attainment, elevation of individual skillsets and employee growth. Fosters a positive, collaborative environment with direct team and matrixed team members by translating organizational direction into specific actions.

SUPERVISORY RESPONSIBILITIES

• Direct Reports (titles):
  • Senior Director Regional Operations
  • Senior Director Business Solutions
  • Senior Director Data Management
  • Director Customer Service
  • Director Eligibility
  • Manager Quality Control & Revenue Recovery
• Indirect Reports (titles)
  • Customer service representative
  • Claims specialist
  • Eligibility coordinator
  • Terms and conditions analyst
  • EDI specialist
  • Revenue recovery analyst

KNOWLEDGE, SKILLS, ABILITIES

• Motivational people management & leadership style with the ability to transform existing functions and align with new organizational growth and requirements.
• Strategic, results oriented, white space thinker; ability to manage ambiguity associated with building a business in an emerging market space, and ability to drive initiatives to closure in this type of environment
• Versatile interpersonal and communication style with the ability to effectively communicate with all levels within and outside the organization.
• Strong project management skills with the ability to multi-task effectively.
• Strong analytical, critical thinking & problem solving skills.

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EDUCATION / EXPERIENCE

• 4 year college degree, advanced degree a plus
• 10+ yearsâ�� experience with progressively increasing responsibilities in health plan or managed care organization operational functions such as claims payments. Additional experience in call centers, provider network administration, information technology, and related areas strongly preferred.
• Experience or training with Medicare, Medicaid, and Commercial managed care products preferred.
• Experience with specifications and business requirements for core managed care information technology systems strongly preferred.
• Experience with EZCap claims system strongly preferred
• Knowledge of value-based and capitated provider risk models

PHYSICAL DEMANDS

• Must be able to work in sitting position, use computer and answer telephone
• Ability to travel

WORK ENVIRONMENT

• Office Work Environment

OTHER

• 0-20% Travel per month based on business need.

Employment practices will not be influenced or affected by an applicant�s or employee�s race, color, religion, sex (including pregnancy), national origin, age, disability, genetic information, sexual orientation, gender identity or expression, veteran status or any other legally protected status. Tenet will make reasonable accommodations for qualified individuals with disabilities unless doing so would result in an undue hardship.