Sr Vice President, Operations

Job Title

Sr Vice President, Operations

Exemption Status

Exempt

Department

Operations Administration

Manager Title

Chief Operations Officer

Direct Reports

Vice President, Operations and Vice President, Network Operations

Requisition #

23890

Pay and Benefits

Estimated hiring range $226,700 - $274,300 / year, 15% bonus target, full benefits.

Posting Notes

This hybrid role will work out of the CareOregon office in Downtown Portland and will occasionally meet with provider partners in the Portland Metro area.

Job Summary

This position is responsible for strategy and excellence for operations shared services at CareOregon. Areas of responsibility span multiple lines of business and include core enterprise operations and innovation. This position will develop and lead the implementation and oversight of a comprehensive strategy for internal and external customers through the delivery of reliable, efficient, and scalable service and support. Primary duties include strategic leadership, planning, and relationships, financial management and guidance, and development and oversight of effective teams.

Essential Responsibilities

Technical/Strategic Leadership

• Provides strategic leadership operations departments fostering a culture of quality, collaboration, accountability, compliance, and continuous improvement.
• Leads multiple complex, large-scale execution tracks simultaneously, maintaining focus of priorities, status, and risks.
• Serves as the enterprise leader for provider network management, member enrollment, and claims, spanning all lines of business, including Medicaid, Medicare, Behavioral Health, Dental Health, and other benefits (as applicable).
• Responsible for successful achievement of department(s) goals, measures, and KPIs for all lines of business and services.
• Evaluates and advises on the impact of long-range planning, introduction of new programs/strategies and regulatory actions.
• Oversees implementation of provider engagement and network strategy; provides input/expertise to member engagement strategy and supports integration such strategies.
• Provides input/expertise to Value Based Payment/Contracting teams who are implementing operational, clinical, and alternative payment initiatives that assures CareOregon is strategically positioned to support its current and future provider network and strategic partners.
• Guides intersections between enterprise matrixed teams, shared services, and regional lines of business.
• Advises executive leadership on emerging market trends, best practices, use of third-party vendors, and technology solutions for core operations and provider network management including digital engagement channels and automation.
• Serves as Executive Sponsor for key projects and initiatives.
• Ensures and measures customer value, satisfaction, reliability, and continuous improvement.
• Drives integration and communication of provider network and contract changes to internal and external stakeholders.

Strategic Planning

• Actively and regularly participates in strategic planning and collaboration at the organizational level.
• Provides counsel to the organization’s executive leadership on specific areas of short and long-term planning.
• Supports emerging opportunity assessments involving the creation or onboarding of new companies or new strategic partnerships.
• Leads the development of vision and goals for areas of oversight.
• Maintains a deep understanding of CareOregon operations and strategic functions, their strengths as well as internal or external threats.

Financial/Resource Management

• Develops, proposes, and oversees substantial budgets in alignment with strategic planning and organizational needs.
• Counsels on financial and labor allocations across the organization, including people, finances, and timelines.

Relationship Management

• Builds and maintains strategic relationships relating to network resilience, VBP contracting, quality improvement, innovation, LOB/regional boards and committees, CAPs, clinical integration programs, funding, assessment, and evaluation.
• Supports strategic relationships with provider stakeholders that include claims payment accuracy and timeliness, payment integrity, innovative network arrangements, and health outcomes accountability.
• Ensures strategic messages are regularly and effectively relayed to appropriate internal and external stakeholders.

Employee Supervision

• Directs teams and establishes team direction and goals in alignment with the organizational mission, vision, and values.
• Identifies work and staffing models; recruits, hires, and oversees a team to meet work needs, using an equity, diversity, and inclusion lens.
• Identifies department priorities; ensures employees have information and resources to meet job expectations.
• Leads the development, communication, and oversight of team and individual goals; ensures goals, expectations, and standards are clearly understood by staff.
• Manages, coaches, motivates, and guides employees; promotes employee development.
• Incorporates guidance from CareOregon equity tools into people leadership, planning, operations, evaluation, budgeting, resource allocation, and decision making.
• Ensures team adheres to department and organizational standards, policies, and procedures.
• Evaluates employee performance and provides regular feedback to support success; recognizes strong performance and addresses performance gaps and accountability (corrective action).
• Performs supervisory tasks in collaboration with Human Resources as needed.

Organizational Responsibilities

• Perform work in alignment with the organization’s mission, vision, and values.
• Support the organization’s commitment to equity, diversity, and inclusion by fostering a culture of open mindedness, cultural awareness, compassion, and respect for all individuals.
• Strive to meet annual business goals in support of the organization’s strategic goals.
• Adhere to the organization’s policies, procedures, and other relevant compliance needs.
• Perform other duties as needed.

Experience and/or Education

Required

• Minimum 10 years’ related experience, including the following:
  • 5 years of network management experience in managed care
  • 5 years of relevant health plan operations experience

Preferred

• Minimum 5 years’ experience in a supervisory position

Knowledge, Skills and Abilities Required

Knowledge

• Advanced knowledge of managed health care, applicable laws, and relationship value with provider networks
• Advanced knowledge of clinical workflows and electronic health record systems within primary care
• Thorough knowledge of principles and statistical methodologies for program assessment and evaluation
• Strong understanding of financial structures, fiscal responsibility, and the economic impact of business decisions

Skills and Abilities

• Leadership effectiveness and ability to design and implement constructive change
• Ability to negotiate and execute complex contractual relationships to align with specific corporate initiatives, strategies, goals, and objectives
• Exceptional relationship-building skills to promote an open and positive atmosphere
• Excellent presentation skills; ability to speak clearly and persuasively in positive or negative situations
• Ability to effectively communicate verbally and in writing organizational mission, vision, and goals to all levels of the organization
• Ability to develop and lead high performing teams, including hiring, goal setting, coaching, performance management, and development
• Ability to make complex and timely decisions, exhibiting sound and accurate judgment
• Extensive data analysis skills derived from formal statistical knowledge and training
• Strong analytical and problem-solving skills
• Ability to work effectively with diverse individuals and groups
• Ability to learn, focus, understand, and evaluate information and determine appropriate actions
• Ability to accept direction and feedback, as well as tolerate and manage stress
• Ability to see, read and hear for at least 6 hours/day
• Ability to speak clearly and perform repetitive finger and wrist movement for at least 3-6 hours/day

Working Conditions

Work Environment(s): Indoor/Office Community Facilities/Security Outdoor Exposure

Member/Patient Facing: No Telephonic In Person

Hazards: May include, but not limited to, physical and ergonomic hazards.

Equipment: General office equipment

Travel: May include occasional required or optional travel outside of the workplace; the employee’s personal vehicle, local transit or other means of transportation may be used.

#Li-Hybrid

Candidates of color are strongly encouraged to apply. CareOregon is committed to building a linguistically and culturally diverse and inclusive work environment

Veterans are strongly encouraged to apply.

Equal opportunity employer. This company considers all candidates regardless of race, color, religion, sex, sexual orientation, gender identity, national origin, disability or veteran status.