This position reports directly to the Chief Operations Officer, and will lead a team of the following (specific numbers dependent on market growth, health plan providers, and geographic footprint):
• Network management representatives,
• Account management support (project manager), and
• Team of community outreach/marketing specialists.
ESSENTIAL DUTIES AND RESPONSIBILITIES
• Has overall P&L accountability for the Concerto Population Health Platform (MSO) line of business within the market.
• Develops the business plan and defines the operational roadmap to successfully achieve Concerto business objectives within the contract requirements of the health plan or provider customer.
• Is the executive ambassador between Concerto and the health plan partner or provider customer from new product implementations through ongoing contract management, with full accountability for the local relationship relative to meeting the expected value proposition, service levels and performance metrics.
• Integrates the strategy, priorities, resources and operations of Concerto’s internal functional business units to drive accountability and ownership for contract performance management.
• Creates alignment between Concerto’s innovative population health platform and payors, health systems and providers making the transition to value based payment in the government sponsored program space with the objective to drive opportunities for growth.
• A connector in the local health care community with an ability to leverage relationships to achieve impactful growth and care delivery outcomes.
• Establishes relationships with field marketing organizations, brokers and other community organizations to market the Concerto care model, provider network and health plan partners.
• Directs and manages a team of community based resources to drive provider and patient engagement, each of which is designed with the goal of improving quality and providing exceptional care.
• Accountable for patient and membership retention initiatives.
• Supports health plan network physicians in their path to value based care delivery through education, point of care tools and actionable information designed to achieve improved quality, experience and efficiency.
• Facilitates opportunities for improved quality and care coordination with physician and facility partners, and serves as a liaison between health plan partners to improve performance in value based reimbursement mechanisms.
• Data focused and outcomes driven, with a deep understanding of clinical delivery systems and the ability to influence provider behavior using data and health information technology.
• Establishes forums to create meaningful dialogue among community providers with the goals of sharing best practices in value based care delivery (including reimbursement and incentive methodologies), providing feedback on resource enhancement, and to promote improved patient care and experience.
• Builds strong partnerships with community organizations, both as an extension of the multidisciplinary care model and delivery system, and as a channel to execute on grass roots growth strategies.
• Must have demonstrated success in executing on a business plan in a value based environment.
• Must have a strong cross functional, operational acumen (understanding of key workflows and operational dependencies), preferably from a health plan, full risk medical group/health system or ACO environment.
• Must have demonstrated experience in managing quality and utilization performance through a network of affiliated and/or community providers to drive exceptional population health outcomes.
• Well-connected in the state, and highly networked in the community with the ability to leverage relationships for growth and recruiting.
• Demonstrated experience at delivering excellent partner relationships by delivering on contractual and regulatory commitments.
• Strong knowledge of government programs contractual requirements and third party measures of quality (e.g. HEDIS, CAHPS, STARS, HOS), with a proven track record of executing on both.
• Strong analytical skills, with the ability to interpret and apply data to create opportunities that will drive membership, improve quality and optimize efficiency.
• Has an executive presence and poise in meeting with payor partner executives, community leaders and Concerto corporate executive team members.
• Proven track record of recruiting, hiring and cultivating a high-performance team to ensure effective execution of business plans.
• A minimum of five (5) years in growing product membership through marketing, network partnerships and/or other strategic relationships, with a strong preference for government programs product portfolios.
• Minimum education requirements include a bachelor’s degree in business, marketing, health care administration or a related field, or equivalent experience. A Masters in Business Administration is strongly preferred.
We are an Equal Opportunity Employer
CONCERTOHEALTH IS AN ALCOHOL/DRUG/SMOKE-FREE WORKPLACE