The Vice President, Health Care Consulting will work closely with the CEO; Executive Vice President, Health Care Consulting; and other COPE Health Solutions team members as appropriate, to lead the development of consulting and business development opportunities, management of engagements (with a focus on leading clients through the process of enhancing clinical integration), establishing population health and restructuring financial alignment toward the accomplishment of the triple aim. The VP, Health Care Consulting will specifically focus on and be responsible for the following areas:
- Actively support consulting business development including development of targeted sales strategies and market research for penetration within California, the Southwestern and the Northeastern U.S.
- Develop value-add consulting services and products for hospitals, health plans and mid- to large-size physician organizations
- Support the Executive VP, Health Care Consulting in developing, implementing and maintaining consulting engagement standards and training for the consulting division, including provision of technical quality assurance for engagement deliverables
- Cross-sell consulting services in tandem with the Health Care Talent Innovations team for their client base
The VP, Health Care Consulting must be willing to travel up to 80% and support our business in New York, California, Texas and other assigned locations. They must be able to effectively manage business development, major engagements, projects and team members while maintaining excellent client rapport.
Responsibilities:
- Manage all assigned aspects of consulting engagements and other assigned contracts and projects from scope definition to delivery, assuming ultimate responsibility for contract deliverables, project resourcing and budget management
- Development of proposals for business development in collaboration with organization leadership and team members
- Build and manage relationships with key executives and staff at client sites to ensure the success of the engagement(s), including maintenance of engagement through communication and project management/coordination with assigned clients and stakeholders
- Drive the development of a market research and sales strategy for health plans, healthy systems and major medical groups in the Western U.S.
- Support the development and maintenance of the Health Care Consulting team of consultants, senior consultants, business analysts, senior advisors and others as appropriate, ensuring that there is ongoing recruitment and retention of team members with the right competencies and expectations, and that profitable annual growth can be maintained
- Provide support to all company team members in areas including general business/product development; market research; process improvement/performance excellence and provision of consulting services to clients
- Develop, update and disseminate knowledge documents related to areas of expertise, such as organizational excellence, revenue cycle, strategic planning and clinical integration
- Develop peer-reviewed articles, sales materials, case studies, internal curricula and trainings
- Represent the company, and client(s) as appropriate, at various professional networking, public relations, business development and fundraising events
- Provide excellence in internal and external customer service
- Ensure compliance with all local, state and federal regulations and ethical standards, as well as COPE Health Solutions employee expectations
- Serve as a mentor to team members throughout the company
- Carry out other duties, tasks and projects as assigned
Qualifications:
- 10-15 years of consulting experience with the majority spent in a management or subject matter expert role
- Advanced degree in an applicable field (MBA, MPH, MHA) required
- Must be able to work collaboratively and effectively while handling multiple projects on various timelines in an extremely fast-paced environment
- Prior experience in at least two of the following areas strongly preferred:
Network Development
- 10-15 years of Network Development experience
- Experienced in building networks for payers, ACOs, IPAs and health systems
- Development of provider criteria, performance management
- Deep experience particularly in Medicaid/Medicare
- Understands regulatory requirements for network adequacy, narrow networks, referrals management
- Abilty to travel and be able to work w/ team in NYC.
Care Management
- 10-15 years of Managed Care Contracting experience
- Experience in IPAs, ACOs, clinically integrated health systems
- Deep experience particularly in Medicaid/Medicare
- Risk based payor and provider contracting
- Developed and managed contracting and financial models for voluntary and employed physicians
- Develop physician compensation plans, incentive structures, benchmarking
- Ablility to travel and be able to work w/ team in NYC
Clinical Redesign
- 10-15 years of Clinical Redesign experience
- RN/Nursing background is a plus
- Experience in strategy and implementation of population health and clinical redesign for primary care, specialty care, practice transformation
- Examples of work would include: ED triage strategies, specialty care redesign, econsult, disease management, referrals management
- Worked within IPAs, ACO, population health vendors that have done implementation, ie Lumeris, Evolent, Conifer
- Deep experience in Medicaid and Medicare
Behavioral Health
- 10-15 years ofIntegrated Care – Behavioral health (substance use, physical health and APM) Program Development and Operations:
- Medicaid Managed Care or Advantage:
- How to address APM and how the priority needs of TX Medicaid will be addressed, including social determinants of health:
- Innovative care models:
- IDD, LTSS and HCBS experience:
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RFP – Proposal writing experience addressing the following:
- Service Coordination
- Network Adequacy and Access to Care
- Provider Relations
- Quality
- Member Services
- Behavioral Health Services
- LTSS and Nursing Facility Services
- Disease Management Program
- Utilization Management
- Alternative Payment Models
- Pharmacy Benefits
- Travel is an essential component of this position, up to 80%
- A strong understanding of the health care industry, analytical thinking skills and a strong and dedicated work ethic are required
- Strong customer drive and dedication to quality and success
- Detail-oriented and able to work well independently
- Superior creative problem-solving, analytical and quantitative skills
- Ability to visualize, identify and pursue opportunities to partner with external institutions
- Excellent oral and written communication skills with an ability to share and synthesize knowledge
- Ability to provide timely and effective feedback to project staff and team members
- Develop external relationships and networks to support business development and professional growth
- Able to work collaboratively and effectively while handling multiple projects on various timelines in an extremely fast-paced environment
- Flexible with work hours, able to travel, and be able to work evenings and weekends frequently
- Expertise in relevant areas that include health care financing, strategic planning, clinical integration, population health, policy, change management, performance excellence/process improvement (to include, but not limited to Lean/Six Sigma)
- High level of proficiency in Microsoft Office suite (Outlook, Word, Excel, PowerPoint and Project Management)
- Experience in project management or training in project/program management methodology (PMBOK), PMP certification preferred
Benefits:
As a firm passionate about health care, weâre deeply committed to the health and wellness of our own team members. We offer comprehensive, affordable insurance plans for our team and their families, and a host of other unique benefits, such as a yearly stipend for wellness-related activities, no cost gym memberships and a paid parental leave program. You can learn more about our benefits offerings here: https://copehealthsolutions.com/careers/why-cope-health-solutions/
To Apply:
To apply for this position or for more information about COPE Health Solutions, visit us at https://copehealthsolutions.com/careers/open-positions/.
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