MANAGER OF VALUE-BASED PRODUCTS - HEALTH PLAN SERVICES
Cook County Health
| Job Description
This position is exempt from Career Service under the CCH Personnel Rules. Job Summary The Manager of Value-Based Products will support value-based arrangements aimed at improving quality, enhancing experience, promoting equity, and reducing costs for patients and members served by Cook County Health (CCH). This position will be responsible for negotiating and administering delegated risk arrangements on behalf of Cook Medical Group (CMG) locations throughout Cook County. Currently, Cook Medical Group holds a delegated, partial-risk commercial contract with Blue Cross Blue Shield Illinois (BCBS IL) for employer and marketplace plans and the Manager will lead the day-to-day operations for this agreement. General Administrative Responsibilities Collective Bargaining * Review applicable Collective Bargaining Agreements and consult with Labor Relations to generate management proposals * Participate in collective bargaining negotiations, caucus discussions and working meetings Discipline * Document, recommend and effectuate discipline at all levels * Work closely with labor relations and/or labor counsel to effectuate and enforce applicable Collective Bargaining Agreements * Initiate, authorize and complete disciplinary action pursuant to CCH system rules, policies, procedures and provision of applicable collective bargaining agreements Supervision * Direct and effectuate CCH management policies and practices * Access and proficiently navigate CCH records system to obtain and review information necessary to execute provisions of applicable collective bargaining agreements Management * Contribute to the management of CCH staff and CCH' systemic development and success * Discuss and develop CCH system policies and procedures * Consistently use independent judgment to identify operational staffing issues and needs and perform the following functions as necessary; hire, transfer, suspend, layoff, recall, promote, discharge, assign, direct or discipline employees pursuant to applicable Collective Bargaining Agreements * Work with Labor Relations to discern past practice when necessary Typical Duties * Develops and implements workflows, trainings, and policies and procedures to support risk-based arrangements * Collaborates with senior leaders in clinical, care coordination, customer service, and other departments to deliver excellent quality of care and experience * Analyzes data and prepares financial, clinical, and operational reports * Liaises with BCBS IL and other payers on behalf of CMG * Manages and oversees CMG staff and other contracted vendors * Supports the negotiation and execution of provider and vendor agreements * Ensures all managed care contract requirements are met * Facilitates monitoring and auditing of CMG-related operations * Supports members and providers with issue resolution * Identifies and implements process improvements with focus on achieving better quality outcomes, enhancing experience, promoting equity, and controlling costs * Identifies and pursues opportunities for expansion and innovation in value-based care, with initial focus on CMG commercial products * Performs other duties as assigned Minimum Qualifications * Bachelor's degree from an accredited college or university is required (Official transcripts are due at the time of interview) * Three (3) years' experience in healthcare administration or managed care supporting Medicare, Medicaid and/or Commercial insurance products is required * One (1) year of experience with value-based contracting and/or delegation in a managed care setting is required * Experience with health plan operations, such as claims processing, network management, utilization management, care management and/or member services is required * Proficiency in Microsoft Office (PowerPoint, Word, Excel, and Outlook) is required Preferred Qualifications
Knowledge, Skills, Abilities and Other Characteristics * Knowledge of the planning, design, development, implementation, and evaluation of policies and procedures * Excellent program development, management, and leadership skills * Excellent verbal and written communication skills necessary to communicate with all levels of staff and a patient population composed of diverse cultures and age groups * Excellent negotiation and presentation skills * Ability to analyze large datasets to evaluate operational, clinical, and financial performance * Ability to prioritize work and multi-task * Attention to detail * Ability to facilitate oversight and audits to ensure program integrity
* Ability to work collaboratively to achieve project goals * Ability to maintain a professional demeanor and composure when challenged Physical and Environmental Demands This position is functioning within a healthcare environment. The incumbent is responsible for adherence to all hospital and department specific safety requirements. This includes but is not limited to the following policies and procedures: complying with Personal Protective Equipment requirements, hand washing and sanitizing practices, complying with department specific engineering and work practice controls and any other work area safety precautions as specified by hospital wide policy and departmental procedures. The above statements are intended to describe the general nature and level of work being performed by people assigned to this classification. They are not intended to be construed as an exhaustive list of all responsibilities, duties and skills required of the personnel so classified. For purposes of the American with Disabilities Act, "Typical Duties" are essential job functions. VETERAN PREFERENCE
PLEASE READ
When applying for employment with the Cook County Health & Hospitals System, preference is given to honorably discharged Veterans who have served in the Armed Forces of the United States for not less than 6 months of continuous service To take advantage of this preference a Veteran must: Meet the minimum qualifications for the position. Identify self as a Veteran on the employment application by answering yes to the question by answering yes to the question, "Are you a Military Veteran?"
Attach a copy of their DD 214, DD 215 or NGB 22 (Notice of Separation at time of application filing. Please note: If you have multiple DD214s, 215s, or NGB 22S, Please submit the one with the latest date. Coast Guard must submit a certified copy of the military separation from either the Department of Transportation (Before 9/11) or the Department of Homeland Security (After 9/11). Discharge papers must list and Honorable Discharge Status. Discharge papers not listing an Honorable Discharge Status are not acceptable OR
A copy of a valid State ID Card or Driver's License which identifies the holder of the ID as a Veteran, may also be attached to the application at time of filing.
If items are not attached, you will not be eligible for Veteran Preference
VETERANS MUST PROVIDE ORIGINAL APPLICABLE DISCHARGE PAPERS OR APPLICABLE STATE ID CARD OR DRIVER'S LICENSE AT TIME OF INTERVIEW.
BENEFITS PACKAGE
You may also qualify for the Public Service Loan Forgiveness Program (PSLF) For further information on our excellent benefits package, please click on the following link: http://www.cookcountyrisk.com/
MUST MEET ALL REQUIRED QUALIFICATIONS AT TIME OF APPLICATION FILING.
*Degrees awarded outside of the United States with the exception of those awarded in one of the United States' territories and Canada must be credentialed by an approved U. S. credential evaluation service belonging to the National Association of Credential Evaluation Services (NACES) or the Association of International Credential Evaluators (AICE). Original credentialing documents must be presented at time of interview. *Please note all offers of employment are contingent upon the following conditions: satisfactory professional & employment references, healthcare and criminal background checks, appropriate licensure/certifications and the successful completion of a physical and pre-employment drug screen.
*CCHHS is strictly prohibited from conditioning, basing or knowingly prejudicing or affecting any term or aspect of County employment or hiring upon or because of any political reason or factor.
COOK COUNTY HEALTH & HOSPITALS SYSTEM IS AN EQUAL OPPORTUNITY EMPLOYER
|
| Assistant Dean of Marketing and Recruitment | San Diego, California |
| University of San Diego | 3 Weeks Ago |