This position will oversee local initiatives aimed at transforming the health of members enrolled in PacificSource’s risk accepting entity with Legacy within the Health Share of Oregon CCO. This position will work closely with providers, community partners, and other stakeholders; develop and lead community based health improvement endeavors in order to advance healthcare’s Quadruple Aim; and inform strategic direction both internally and externally to effectuate initiatives that improve overall transformation efforts in the region. This may include pursuing goals around quality, cost, and health improvement on behalf of its Medicaid members, participating in community and consumer driven governance models, leading multi-stakeholder strategic planning efforts, and effectuating internal or external work plans.
External Collaboration (40%)
Build and maintain relationships with PacificSource’s Medicaid community governance partners, Legacy, governance staff and leaders, providers, community leaders, and other external stakeholders.
Align PacificSource and community partner interests to accomplish common, community-level health outcomes.
Engage in Health Share’s governance model by participating in the local Board and subcommittee activities, standing work groups, and ad hoc committees.
Maintain a visible leadership role in the communities we serve to ensure that PacificSource is represented, if not leading, critical initiatives impacting the Medicaid line of business and membership in this arrangement.
Collaborate to ensure the success of community partners who are serving the Medicaid line of business to the extent such partnerships also improves the PacificSource Medicaid performance goals.
Assume a central role in working with providers, county health departments, the State of Oregon, and other partners to orchestrate and execute care model improvements for CCO members.
Business and Operating Objectives (20%)
Develop strategic business partnerships with local government, providers, agencies, and internal PacificSource leaders to ensure priority Medicaid objectives are consistently accomplished.
As assigned, lead internal work groups to ensure performance of PacificSource’s Medicaid initiatives, with an emphasis on local initiatives. These may include financial and operating performance, utilization management, care management, quality of care, member engagement and satisfaction, provider access and engagement, local transformation projects, State contractual deliverables, and compliance.
Build and maintain relationships with key departments and personnel within the State of Oregon under the direction and guidance of PacificSource leadership.
Help to develop business plans and contract language for collaborative community health projects, ensuring that successful initiatives have a positive impact on both the organization, and the community. Oversee & delegate project management for some initiatives.
Manage local transformation efforts, including monitoring project finances, outcomes, and process objectives. Ensure that PacificSource and community projects stay on track by coordinating efforts internally and externally.
Support and lead Health System Transformation and CCO procurement efforts in collaboration with PacificSource leaders.
Internal Alignment and Engagement (20%)
Work directly with department leaders to ensure knowledge, priorities, and actions accomplish line of business aims on behalf of PacificSource members and community partners.
Collaborate with other PacificSource CCO Directors to support governance objectives throughout the Medicaid line of business and support executive leadership in meeting regional needs.
Maintain collaborative partnerships with key PacificSource departments and leaders.
Actively participate as a key team member in company leadership meetings.
Actively participate in various strategic and internal committees in order to disseminate information within the organization, representing company philosophy, and ensuring line of business visibility within the community.
Development and growth opportunities (20%)
Work with other leaders to implement growth opportunities in product design, benefit, operating, clinical, cost savings, or network changes.
Help to ensure internal PacificSource operations synergize with the core competencies of external community partners. Improve Medicaid member experience and quality of care by effectively leveraging PacificSource’s core competencies and those of its partners.
Manage Community Health Improvement Plan initiatives from concept to development and guide implementation to ensure performance goals are met and to maintain alignment with broader CCO & PacificSource corporate strategies.
Work Experience: Minimum of 5 years leadership experience in the health care industry, provider organization, or related area. Relevant experience in the following areas: managing healthcare operations, community health, strategic planning, business development, quality improvement, strategic relationship development, workforce innovation, population health improvement. Experience leading large multi-stakeholder initiatives highly desired. Experience in managing complex projects or project management certification is desirable. Demonstrated financial analysis and modeling comprehension, and proven negotiations experience. Demonstrated ability to develop and execute strategy. Significant technical writing experience required. Candidates with significant experience with the Willamette Valley region and local partnerships are strongly encouraged to apply.
Education, Certificates, Licenses: Masters in Public Health, Healthcare Administration, Business, or related field strongly desired. Bachelors or equivalent degree required.
Knowledge: Excellent public relations, presentation, and interpersonal skills. Demonstrated successful communication skills, including public presentation, training, meeting facilitation, and written materials. Maintain high level of knowledge of company products, health reform trends at the Federal and State levels, and the insurance industry. Demonstrated skills with the following software: Microsoft Word, PowerPoint, Excel, and Visio. Strong analytical and problem solving skills.
Environment: Work inside in a general office setting with ergonomically configured equipment. Travel is required approximately 20% of the time.
Physical Requirements: Sit and/or stand for extended periods of time while performing core job functions. Repetitive motions to include typing, sorting and filing. Light lifting and carrying of files and business materials. Ability to read and comprehend both written and spoken English. Communicate clearly and effectively.
Diversity and Inclusion: PacificSource values the diversity of the people we hire and serve. We are committed to creating a diverse environment and fostering a workplace in which individual differences are appreciated, respected and responded to in ways that fully develop and utilize each person’s talents and strengths.
Disclaimer: This job description indicates the general nature and level of work performed by employees within this position and is subject to change. It is not designed to contain or be interpreted as a comprehensive list of all duties, responsibilities, and qualifications required of employees assigned to this position. Employment remains AT-WILL at all times.
PacificSource is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to status as a protected veteran or a qualified individual with a disability, or other protected status, such as race, religion, color, national origin, sex, sexual orientation, gender identity or age.
Internal Number: 2019-518
We would all like to believe that the work we do matters. And at PacificSource, our employees know they help people get the healthcare they need. We believe our employees are the key to our company’s success, which is why we extend the same care and consideration to our staff as we do to our customers.
Building on a tradition of exceptional customer service and community involvement that started in 1933, we put a human face on health insurance and benefits administration—every day.
- We are committed to doing the right thing.
- We are one team working toward a common goal.
- We are each responsible for our customers’ experience.
- We practice open communication at all levels of the company to foster individual, team and company growth.
- We actively participate in efforts to improve our many communities-internal and external.
- We encourage creativity, innovation, continuous improvement, and the pursuit of excellence.