Director of Clinically Integrated Network in Helena, MT.  FT position responsible for the planning, development, implementation, and ongoing management of Montana Health Plus (MTH+).

Requires a minimum a Bachelor’s Degree and 5+ years of experience with healthcare management, knowledge of healthcare finance and/or managed care. Master’s Degree preferred.  Leadership experience within a community-based health care system.  Preference given to experience with mission-based organizations, Federally Qualified Health Centers, and /or managed care organizations. Dual reporting to a Board of Directors and CEO.  Candidate must live in Montana. Benefit package. Salary DOE.  Open until filled.

POSITION SUMMARY:

The Director of Montana Health Plus will be responsible and accountable for the planning, development, implementation, and ongoing management of Montana Health Plus (MTH+).

The Director will lend leadership and administrative expertise to provide an environment that encourages the highest quality healthcare while simultaneously reducing the total cost of care. This will require a high level of clinical integration, coordination, and alignment between the common participants of MTH+ and Montana Primary Care Association.

REPORTING RELATIONSHIPS:

The Director of Montana Health Plus reports directly to the Chief Executive Officer of Montana Primary Care Association and to the Board of Directors of Montana Health Plus.  The Board oversees the strategic direction and holds the fiduciary responsibilities for MTH+.

MAJOR RESPONSIBILITIES:

·         The Director will be responsible for all operations of Montana Health Plus (MTH+) to meet the overall goal of delivering healthcare that meets the emerging need for value (cost, quality, and service) and ensure the viable growth of the network.

·         Coordinate with leadership to develop, implement and support the infrastructure of MTH+ and responsible for administrative oversight of MTH+ Board meetings, activities and board committees.

·         Further develop, communicate, and effectuate policies of the Board of Directors and ensure adherence to all aspects of policies and operating agreements.  Coordinate with MPCA that there is alignment with MPCA policies practices and procedures.

·         Optimize collaboration with MPCA and Health Center Controlled Network to ensure alignment of activities to the greatest extent possible and maximize alignment of activities within our common members.

·         Provide managerial oversight of all MPCA staff performing tasks on behalf of MTH+ to include setting expectations, priorities, goals and ensuring accountability.  Coordinate with direct supervisors to manage workload and expectations.

·         Develop a budget for approval by Montana Health Plus Board of Directors and oversee adherence and resource allocation as deemed necessary for success.

·         Create and manage the processes required by funds distribution policies of the Board of Directors and accurately distribute and track funds accrued through shared savings.

·         Regularly report MTH+ operational progress, financial progress and summative performance metrics to the members and Board of Directors and its’ committees.

·         Optimize current and design/negotiate new value-based contracts with payers and health plans.

·         Establish regular communication and a working relationship with payers and health plans and stay attuned to the payer environment.

·         Maintain the operational effectiveness of MTH+ as measured through metrics established in the areas of quality outcomes, access, and cost-effectiveness while ensuring metrics are relevant and appropriate to the overall strategy of MTH+’s payor engagement.

·         Develop, oversee and continually improve MTH+’s non-clinical operations including those related to analytics & reporting, compliance, credentialing, and finance.

·         Work with the MTH+ clinical leadership to support the implementation of programs designed to ensure the use of best practices, continuous outcomes improvement, and the appropriate level of care coordination/transitions in care management for the level of severity of each patient.

·         Collaborate with MPCA Finance and Health Center Controlled Network and other entities to ensure processing of monthly claims data, regular reporting of summative quality data, patient attribution lists, utilization and cost of care data, timely risk adjustment and population segmentation.

EXPERIENCE & QUALIFICATIONS:

Requires Bachelor’s Degree and 5+ years of experience with healthcare management,

provider quality improvement leadership, knowledge of healthcare finance and/or managed

care. Master’s Degree preferred.

Specific experience in creating clinical value with improved processes, outcomes, and the lowering of the cost of care, and optimizing performance under shared risk contracts.

Knowledge of federally qualified health centers, population health, care continuum, value-based care, managed care contracting and strategy, and population-based quality programs.

To apply, please send cover letter and resume to cstergar@mtpca.org

Benefits: Full benefits