Vice President, Provider Experience

Date: Sep 20, 2022

Location: Rancho Cucamonga, CA, US

Company: Inland Empire Health Plans

Job Requisition ID: 8070 

 

Position Summary/Position

 

Under the direction of the Chief Operating Officer, the Vice President, Provider Experience is responsible for providing senior level leadership, guidance to the Provider Communications, Provider Network, Provider Operations, and Provider Relations teams. This position will provide oversight over all aspects of the provider network strategy, including but not limited to: Member access analysis, network communications and network operations. The incumbent will create and develop strategic alliances and relationships, as well as foster new Provider engagement opportunities. The Vice President, Provider Experience serves as an internal advocate and the voice of the Provider. This position brings awareness to IEHP Executives and Departments on how their work impacts the network.

Major Functions (Duties and Responsibilities)

 

1. Strategic Provider partner for all products (Medi-Cal, Medicare, and Commercial).  Optimizes the IEHP Provider network development to meet strategic plans in IEHP market expansion.
2. Accountable for assessing, developing and maintaining Provider engagement and networks for the organization. 
3. Provide direct leadership, oversight, and accountability for the effectiveness of the Provider Communications, Provider Network, Provider Operations, and Provider Relations teams through the development of an annual workplan that aligns with the organizational priorities which includes key infrastructure projects, training & development plans, and actions focused on continuous improvement of the team’s culture and engagement.  
4. Establish assessment processes and procedures for the departmental infrastructure and staffs to ensure quality of work meets expectations.    Drive engagement within the Provider Services Department leaders to build strong and clear interrelationships to ensure successful operational performance, Provider support and Provider data integrity. 
5. Oversee the Provider network adequacy for current and future coverage areas, including timely and successful onboarding. 
6. Identify areas of improvement and leads projects and continuous improvement initiatives for the Provider Communications, Provider Network, Provider Operations, and Provider Relations teams.  Anticipate operational challenges and proactively identify and execute solutions to mitigate obstacles.  
7. Develop and maintain positive relationships with IEHP’s Provider partners to achieve shared success.  Serves as the organization’s escalation contact for Provider partners.  
8. Work closely with IEHP’s VP Quality and VP Health Services Clinical Integration & Operations to enhance Provider satisfaction, productivity, and performance.
9. In coordination with IEHP’s organization-wide operations, non-operations, and clinical teams, monitors performance, removes barriers, develops and implements strategies that enable Provider adoption and success. 
10. Monitor developments on the federal and state level that may impact the Provider Communications, Provider Network, Provider Operations, and Provider Relations teams.  Develops appropriate strategies as necessary and implements corrective actions as appropriate.
11. Ensure regulatory documentation prepared by the Provider Communications, Provider Network, Provider Operations, and Provider Relations teams is accurate and meets regulatory requirements.  Participates in audits and interacts with regulatory agencies as a credible, influential, and respected leader.   
12. Responsible for IEHP and Provider Network relationship in areas such as Provider Network requirements compliance, incentive programs, communication, initiatives implementation, Provider satisfaction, and other areas.   
13. Meet and communicate regularly with organization-wide operations, non-operations, and clinical leaders to evaluate existing programs, plan, and implement new programs that support identified Provider needs.
14. Cultivate and maintain positive working relationships at all levels of the organization to ensure positive collaboration to identify, assess, and prioritize upstream and downstream impacts of the Provider initiatives throughout the organization.

Major Functions (Duties and Responsibilities) Cont

Supervisory Responsibilities

Leader: Administers Hires, Terminations, and Performance Reviews

Experience Qualifications

 

A minimum of ten (10) years of experience in a leadership position within the health plan administration function. Demonstrated experience with physician leaders and Provider groups.  

Preferred Experience

Education Qualifications

 

Master’s degree in a related field from an accredited institution required.


Significant experience may be considered in lieu of a Master’s degree: In lieu of a Master’s degree, a minimum of a Bachelor’s degree from an accredited institution is required in addition to a total of fourteen (14) years of relevant work experience is required.


Significant experience may be considered in lieu of both a Master’s degree and Bachelor’s degree: In lieu of both a Master’s degree and Bachelor’s degree, a minimum of to a total of twenty-two (22) years of relevant work experience is required.

Preferred Education

Professional Certification

Professional Licenses

Drivers License Required

Yes, must have a valid California Driver's License.

Knowledge Requirement

 

Strong knowledge of the following:
- Managed care, government programs, or other product lines.
- Healthcare, health plans and/or health plan accreditation principles and practices, in directing operations within the organization. 
- Regulatory and compliance requirements related to Medi-Cal, Medicare of Commercial products, including but not limited to the California Knox-Keene Healthcare Service Plan Act and Regulations.
- Demonstrated knowledge of health plan operations.

Skills Requirement

 

- Strong leadership skills required including team development, mentoring, and coaching, and personnel management.
- Strong interpersonal and relationship building skills; ability to develop strategic partnerships both internally and externally. 
- Excellent communication skills; verbal and written.

Abilities Requirement

 

- Work independently and collaboratively within a team environment to deliver results.
- Manage multiple projects with competing deadlines and changing priorities with proven execution against aggressive objectives.
- Partner with external stakeholders to execute goals and initiatives of the organization. 
- Ability to drive alignment across executives and peers at all levels in the organization. 
- Work in a complex, rapidly evolving environment which requires high-level initiative, and judgment necessary to bring resolution to sensitive issues.
- Communicate effectively to a variety of audiences in small or large group settings.
- A high level of diplomacy is necessary to anticipate, recognize and deal effectively with sensitive network issues.
- Strong organizational skills and attention to detail.

Commitment to Team Culture

 

The IEHP Team environment requires a Team Member to participate in the IEHP Team Culture. A Team Member demonstrates support of the Culture by developing professional and effective working relationships that include elements of respect and cooperation with Team Members, Members, and associates outside of our organization.

Working Conditions

Work Model Location

Hybrid

Physical Requirements

Extension of the neck - CONSTANTLY
Flexion of the neck - CONSTANTLY
Twisting of the neck - CONSTANTLY
Reaching (above shoulder level) - FREQUENTLY
Hearing: Conference Speakers/Video Calls/Radio Calls - CONSTANTLY
Hearing: In a group - CONSTANTLY
Hearing: One-on-One - CONSTANTLY
Hearing: Other sounds - CONSTANTLY
Hearing: Over the Telephone/Cell Phone - CONSTANTLY
Communicate: Information/ideas verbally - CONSTANTLY
Communicate: Verbally engage with customer base - CONSTANTLY
Near Visual Acuity - CONSTANTLY
Peripheral Vision - CONSTANTLY
Perform complex and varied tasks - CONSTANTLY
Develop and maintain positive work relationships - CONSTANTLY
Adaptability: rate of change in work location - CONSTANTLY
Adaptability: rate of change in work schedule - CONSTANTLY
Adaptability: rate of change in work tasks - FREQUENTLY
Regular contacts: co-workers, supervisor - CONSTANTLY
Regular contacts: recurring clients - CONSTANTLY
Other contacts: public exchange - CONSTANTLY
Other contacts:one-time clients - CONSTANTLY
Decision-making - CONSTANTLY
Lead/Influence Others - CONSTANTLY
Work review - CONSTANTLY
Rapid Pace of work - CONSTANTLY
Control of work pace - CONSTANTLY
Pace of work with faster/slower work periods - CONSTANTLY
Problem Solving - CONSTANTLY
Memory - CONSTANTLY
Understand and follow direction - CONSTANTLY
Regular and reliable attendance - CONSTANTLY
Keyboarding: 10-Key - CONSTANTLY
Keyboarding: Other - CONSTANTLY
Keyboarding: Traditional - CONSTANTLY
Keyboarding: Touch-Screen - CONSTANTLY
Use of computer mouse - CONSTANTLY
Steering - CONSTANTLY
Twisting - FREQUENTLY
Stooping - FREQUENTLY
Bending - FREQUENTLY
Use hands/fingers to handle or feel - CONSTANTLY
Fine manipulation - CONSTANTLY
Simple Grasp - CONSTANTLY
Up and down flexion of wrist - CONSTANTLY
Side to side motion of the wrist - CONSTANTLY
Turning/rotation of wrist or hand - CONSTANTLY
Alternate Sit/Stand or Walk at Will - CONSTANTLY
Standing - CONSTANTLY
Walking - CONSTANTLY
Climbing - FREQUENTLY
Indoors - CONSTANTLY
Lighting - CONSTANTLY
Smells/Scents - FREQUENTLY

 

Starting Salary: $240,676.80  - $330,928.00  

Pay rate will commensurate with experience

 

Inland Empire Health Plan (IEHP) is the largest not-for-profit Medi-Cal and Medicare health plan in the Inland Empire. We are also one of the largest employers in the region. With a provider network of more than 7,000 and a team of more than 2,500 employees, IEHP provides quality, accessible healthcare services to more than 1.5 million members. And our Mission, Vision, and Values help guide us in the development of innovative programs and the creation of an award winning workplace. As the healthcare landscape is transformed, we’re ready to make a difference today and in the years to come. Join our Team and make a difference with us! IEHP offers a competitive salary and a benefit package with a value estimated at 35% of the annual salary, including medical, dental, vision, team bonus, and state pension plan.

 


Nearest Major Market: Riverside
Nearest Secondary Market: Los Angeles