Details
Posted: 14-Jul-22
Location: California
Salary: Open
Categories:
General Nursing
Internal Number: 2205018699
Conifer Health Solutions is a healthcare services company partnering with more than 800 clients to strengthen their financial and clinical performance. With over 30 years of healthcare industry experience in more than 135 local regions, Conifer helps clients transition from volume to value-based care, enhance the patient experience, improve quality and access to healthcare while controlling costs. In all, Conifer manages more than 24 million unique patient interactions, $30 billion in net patient revenue and $21.5 billion in medically managed spend. Conifer also provides technology and health management services to support care management for 5.7 million lives across the US.
JOB SUMMARY
ESSENTIAL DUTIES AND RESPONSIBILITIES
Include the following. Others may be assigned.
- Accountable and responsible for achieving and delivering on organization and client strategic growth and financial (revenue) performance targets. Responsible for the development of client�s strategic initiatives, provides guidance to client team and is responsible for the timely and accurate oversight and implementation of the delegated services to the client.
- Accountable for sales quotas and existing client growth targets and new services and upsell opportunities are realized, including but not limited, adherence to the change control notice (CCN) and deal review committee processes (DRC I and II). Serve as subject matter expert for new client logos. Maintain some level of client executive engagement to ensure existing client referenceability.
- Participate in the CVBC Quality Improvement committee and programs, as well as, supports the development of quality initiatives and interventions. Work with practice and medical management teams on quality initiatives and identifying gaps in care. Direct the execution and delivery of quality improvement objectives.
- Responsible for the client profit and loss performance. Analyze and identify medical revenue and expense trends and variances and works with client and operations team to create financial action plans, as well as, develops the initiatives to manage the medical spend which and realize cost savings.
- Develop and facilitate the business planning process with the client team and organization.
- Work closely with operational and functional department heads to ensure that client business objectives are executed on time.
SUPERVISORY RESPONSIBILITIES
- This position reports to the VP, West Region Provider Practice and requires no degree of supervision to ensure strategic initiatives and client expectations are prioritized, met, and successfully implemented.
Qualifications:Conifer requires its candidates, as applicable and as permitted by law, to obtain and provide confirmation of all required vaccinations and screenings prior to the start of employment activity. This may include, but is not limited to, the COVID-19 vaccination, influenza vaccination, and/or any future required vaccines and screenings.
KNOWLEDGE, SKILLS, ABILITIES
Candidates that exhibit most of the following preferred qualifications will be well suited for this position. However,
- 8+ years of health plan or management service organization experience in managing risk bearing organizations or related area
- 8+ years in managed care experience preferred
- Extensive working knowledge of the risk bearing organization and the delegated UM, Credentialing, Network Management, Customer Service, Finance, and Case Management functions.
- Extensive working knowledge of risk bearing operating and performance revenue and expense levers
- Extensive working knowledge of payor strategies and market layout.
- 4+ years of supervisory experience
EDUCATION / EXPERIENCE
- Bachelor Degree or higher
REQUIRED CERTIFICATIONS/LICENSURE
PHYSICAL DEMANDS
The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
- Must be able to work in a sitting position, use a computer and answer telephone
- Light physical effort (lift to 10 lbs.).
- The home office for this position will be located in Encino, CA.
WORK ENVIRONMENT
The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
- Office Work Environment
- Hospital Work Environment
TRAVEL
- This position requires regional (West Region) and local (50-mile radius) travel and/or may include travel to other service markets 30% of the time.
Job:
Conifer Health Solutions
Primary Location:
California
Job Type:
Full-time
Shift Type:
Days
Employment practices will not be influenced or affected by an applicant�s or employee�s race, color, religion, sex (including pregnancy), national origin, age, disability, genetic information, sexual orientation, gender identity or expression, veteran status or any other legally protected status. Tenet will make reasonable accommodations for qualified individuals with disabilities unless doing so would result in an undue hardship.