VP of Network Operations

DC Primary Care Association is a 25-year old nonprofit health equity and advocacy organization dedicated to improving the health of DC’s vulnerable residents by ensuring access to high quality primary health care.

Our membership currently includes 15 community health centers and community-based organizations located in the District of Columbia and the Maryland suburbs. Between them, our members own and operate nearly 60 health care delivery sites that serve approximately 200,000 residents.

POSITION SUMMARY

The Vice President of Network Operations will support the CEO of DC Primary Care Association (DCPCA) and facilitate planning, development, implementation, and ongoing management of the DC Connected Care Network (DC-CCN).

The VP of Network Operations will ensure that the Network performance aligns with MCO contracting metrics and enable successful Network performance.

Responsibilities

Work effectively with community health center leadership and clinical teams to meet MCO VBC contracting terms and performance requirements.; Stays up to date with current industry and market trends and best practices on financial elements, program structures, ad best practices.; Leads the design and negotiation of new value-based contracts with MCOs.; Coordinate with leadership to develop, implement and support the infrastructure of DC-CCN including but not limited to data and analytics systems, clinical practice transformation support and technical assistance, supports the success and accountability for the Network subcommittees.; Establish regular communication and a working relationship with Medicaid MCOs for network development and to monitor performance, stay attuned to market changes and MCO and stakeholder managed care contract priorities.; Responsible for monitoring results and maintaining the operational effectiveness of the DC-CCN through relevant metrics established in the areas of quality outcomes, access, and cost-effectiveness and proactively identifies issues and proposes actions and recommendations to boost program performance.; Work with the DC-CCN 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 IT leadership 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.; Assist with budget development, develops models to forecast total cost of care and utilization performance, oversee adherence, and resource allocation as deemed necessary for success.; Identifies and implements approved strategic partnerships to enhance performance of the network.; Collaborates with DC-CCN leaders to share specific program performance opportunities with health center leadership.

Requirements

Advanced degree in Health Care Management/Administration preferably in Business Administration, Public Health, or related field.; Five or more years of healthcare leadership and management experience with demonstrated ability in managed care contracting, practice transformation, Value based care performance tracking and systems change.; Specific experience in practice transformation, and documenting clinical value with improved processes, outcomes and the lowering of the cost of care. Ability to optimize performance under total cost of care savings and 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.