UCSF Health
Vice President, Health Plan Strategy and Managed Care, Chief Contracting Officer
UCSF Health, San Francisco, California, United States, 94199
Overview
Vice President, Health Plan Strategy and Managed Care, Chief Contracting Officer (CCO) at UCSF Health. This role establishes strategies for developing the financial, programmatic and operational long-term plans for managed care and health plan partnerships, and strategic program and coverage expansion activities for the health system. The VP/CCO oversees negotiations of substantial importance and impact across the health system. The position reports directly to the SVP and Chief Financial Officer of UCSF Health and is a member of UCSF Health’s Senior Leadership Council (SLC) and the System CFO’s senior leadership team. Responsibilities
Directly responsible for negotiation and management of all UCSF Health’s contracted payer relationships (commercial, governmental and large at-risk referring medical groups). Develop contracting strategies to engage community providers and expand UCSF Health’s regional footprint, including the Community Integrated (physician) Network and regional hospital affiliations. Lead contracting for commercial and governmental transplant Center of Excellence (COE) contracts, risk-bearing Accountable Care Organization (ACO) collaborations, and Health Insurance Exchange (HIE) products. Ensure access for commercial, Medicare Advantage seniors and Medi-Cal Managed Care plan enrollees in local and regional markets. Perform contract modeling, financial performance assessment and negotiation support (business, legal and financial), including EPIC-based calculation of expected payments and monitoring actual contract payments/compliance. Collaborate with Population Health and dyad partners to evaluate and improve cost-effectiveness of care delivery for assigned and referred enrollees, aligning contracting strategies with patient care goals and long-term viability of UCSF Health. Contribute to the execution of the UCSF Clinical Enterprise Plan (5-year plan) with rollout through 2025 and beyond, including new inpatient facilities opening in 2030-2031. Qualifications
Required
Master’s degree in related area and/or equivalent experience/training. 10 years of experience as a leader in health plan strategy or related healthcare industry experience. Strong ability to translate contracting theory and managed care trends into revenue generation and strategic business concepts; apply expertise to abstract concepts and real-time decisions. Knowledge of managed care laws and regulations; ability to develop policy and process improvements. Innovative leadership to motivate and influence, align goals, and lead to industry-leading managed care services. Proven ability to improve managed care operations through IT enhancements; assess impact of IT changes on productivity and quality. Expert capability in strategic planning and implementation for a multi-faceted health system; strong change management and business development skills for negotiating contracts. Strong interpersonal, collaborative, and conflict-management skills to engage stakeholders and achieve win-win outcomes. Analytical problem-solving abilities to evaluate data and communicate impact clearly; strong verbal and written communication and presentation skills. Preferred
Knowledge of UCSF medical center, HR and UC policies and processes. About UCSF
UCSF Health is committed to innovative patient care, advanced technology and pioneering research. UCSF Health is consistently ranked among the top hospitals nationwide and offers opportunities for professional growth in a collaborative environment. Equal Employment Opportunity
The University of California is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, age, protected veteran status, or other protected status under state or federal law. Additional Details
Location: San Francisco, CA (Mission Bay) Job Code: 005755 MGD CARE MGR 4 Employment type: Full-time Job category: Strategy, Supervisory / Management Salary range: $281,700 - $593,100 annually
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Vice President, Health Plan Strategy and Managed Care, Chief Contracting Officer (CCO) at UCSF Health. This role establishes strategies for developing the financial, programmatic and operational long-term plans for managed care and health plan partnerships, and strategic program and coverage expansion activities for the health system. The VP/CCO oversees negotiations of substantial importance and impact across the health system. The position reports directly to the SVP and Chief Financial Officer of UCSF Health and is a member of UCSF Health’s Senior Leadership Council (SLC) and the System CFO’s senior leadership team. Responsibilities
Directly responsible for negotiation and management of all UCSF Health’s contracted payer relationships (commercial, governmental and large at-risk referring medical groups). Develop contracting strategies to engage community providers and expand UCSF Health’s regional footprint, including the Community Integrated (physician) Network and regional hospital affiliations. Lead contracting for commercial and governmental transplant Center of Excellence (COE) contracts, risk-bearing Accountable Care Organization (ACO) collaborations, and Health Insurance Exchange (HIE) products. Ensure access for commercial, Medicare Advantage seniors and Medi-Cal Managed Care plan enrollees in local and regional markets. Perform contract modeling, financial performance assessment and negotiation support (business, legal and financial), including EPIC-based calculation of expected payments and monitoring actual contract payments/compliance. Collaborate with Population Health and dyad partners to evaluate and improve cost-effectiveness of care delivery for assigned and referred enrollees, aligning contracting strategies with patient care goals and long-term viability of UCSF Health. Contribute to the execution of the UCSF Clinical Enterprise Plan (5-year plan) with rollout through 2025 and beyond, including new inpatient facilities opening in 2030-2031. Qualifications
Required
Master’s degree in related area and/or equivalent experience/training. 10 years of experience as a leader in health plan strategy or related healthcare industry experience. Strong ability to translate contracting theory and managed care trends into revenue generation and strategic business concepts; apply expertise to abstract concepts and real-time decisions. Knowledge of managed care laws and regulations; ability to develop policy and process improvements. Innovative leadership to motivate and influence, align goals, and lead to industry-leading managed care services. Proven ability to improve managed care operations through IT enhancements; assess impact of IT changes on productivity and quality. Expert capability in strategic planning and implementation for a multi-faceted health system; strong change management and business development skills for negotiating contracts. Strong interpersonal, collaborative, and conflict-management skills to engage stakeholders and achieve win-win outcomes. Analytical problem-solving abilities to evaluate data and communicate impact clearly; strong verbal and written communication and presentation skills. Preferred
Knowledge of UCSF medical center, HR and UC policies and processes. About UCSF
UCSF Health is committed to innovative patient care, advanced technology and pioneering research. UCSF Health is consistently ranked among the top hospitals nationwide and offers opportunities for professional growth in a collaborative environment. Equal Employment Opportunity
The University of California is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, age, protected veteran status, or other protected status under state or federal law. Additional Details
Location: San Francisco, CA (Mission Bay) Job Code: 005755 MGD CARE MGR 4 Employment type: Full-time Job category: Strategy, Supervisory / Management Salary range: $281,700 - $593,100 annually
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