Virginia Premier Health Plan has retained Morgan Consulting Resources, Inc. to conduct the search for their Vice President, Population Health Outcomes (Quality). This is an outstanding opportunity to be a highly visible member of a dynamic organization. This position will be based in Richmond, Virginia.
About the company:
Virginia Premier Health Plan is a non-profit managed care organization, locally owned by VCU Health. While they are headquartered in Richmond, they also have a presence in Bristol, Wise, Richlands, Winchester, Roanoke, Tidewater and Northern Virginia. This enables them to serve vulnerable populations throughout the state. Virginia Premier Health Plan focuses their resources on member services, offering a Medicaid Plan, Virginia Premier CompleteCare, a plan for those who are dually eligible, Virginia Premier Elite Plus, a plan for those needing long-term services and supports and Virginia Premier Elite, a Medicare Advantage Plan. They opened their first Patient-Centered Medical Home in Roanoke, VA in 2014. Please visit their website at www.vapremier.com.
Virginia Premier Health Plan’s Commitment and Mission Statements:
Commitment: Helping individuals and families find and fund quality healthcare is at the heart of what we do. We fulfil this objective by delivering easy access to doctors, specialists, hospitals, referrals and emergency aid. In doing so, we act as a strong partner for our members in providing for their health and the health of their families.
Mission: Virginia Premier Health Plan, a managed care organization owned by the Virginia Commonwealth University Medical Center, meets the needs of underserved and vulnerable populations in Virginia by delivering quality driven, culturally sensitive and financially viable healthcare.
About the position:
The Vice President, Population Health Outcomes (Quality) is responsible for meeting the requirements of CMS and DMAS for Medicare and Medicaid lines of business. The successful candidate will work collaboratively with the Chief Medical Officer and other key leaders within the leadership team to develop and implement a quality strategy which supports ongoing systemic process improvement. Core functions/services are oversight of the HEDIS, CAHPS, HOS, STARS and Plan accreditation process from data collection and interpretation to implementation of programs and processes designed to improve population health outcomes for VPHP membership and ensure they meet or exceed contractual benchmarks for the quality performance targets. The successful candidate will be responsible for effective working relationships with regulatory/community agencies, providers, hospitals, and departments within Virginia Premier to improve quality, member outcomes and health plan expansion through growth opportunities. This position serves as part of the executive leadership team and has shared accountability for an integrated approach to meeting the overall department and company goals.
The VP of Population Health Outcomes is responsible for strategic clinical plan development and the Quality Management for all lines of business. This position is responsible for developing and coordinating all Quality Improvement Program-related activities, objectives, and analysis including conducting quality improvement studies. They provide ongoing development, maintenance and evaluation of quality systems and strategies focused on NCQA, HEDIS, and CAHPS for all products and services and STARS strategy. This position has oversight responsibilities for the quality of provided service delivery and overall performance reviews. They establish annual work plans and program evaluations, policies, and procedures at all levels to ensure quality programs will meet or exceed guidelines. This position will not only strategically direct the programs and services that support Virginia Premier Health Plan’s relationships with its members, providers, staff members, network, and community, but also align with the overall corporate goals and strategies of VCU Health System.
Required Education and Experience:
•5 years of progressive management experience in the area of Quality.
•Baccalaureate degree. Masters highly preferred.
•Three years of experience and knowledge in managed care, preferably Medicaid and Medicare Advantage.
•Highly motivated individual with the ability to work independently.
•Must possess strong leadership capability, problem-solving and organizational skills, and the desire to foster good working rapport.
•Previous management experience with two years management in the MCO setting.
About Richmond, VA:
Richmond is a city that represents a significant chapter in America’s history, with cobblestone streets, river walks and historical monuments. Originally a colonial settlement, Virginia’s capital is now a thriving hub for culture, shopping and outdoor fun. With lively neighborhoods and a vibrant restaurant scene, Richmond combines big city amenities with southern charm and ease.
If you or someone you know has the qualifications we seek, I'd love to set up a time to talk. Thank you so much for your time.
Morgan Consulting Resources is a women-owned, nationally retained executive search firm with over two decades of experience filling executive roles at healthcare payers and providers and the vendors that support them.