Director, Clinically Integrated Network Operations

Responsibilities

• Develop and execute CIN operational strategies aligned with organizational goals
• Partner with executive leadership to drive value-based care initiatives
• Coordinate all board and governance related activities of the CINDR
• Lead growth and optimization of CIN programs and payer contracts
• Oversee daily CIN operations, including care coordination, network performance, and provider engagement
• Implement workflows to improve efficiency and patient outcomes
• Monitor and improve operational KPIs
• Direct population health strategies, including risk stratification and care management programs
• Ensure effective transitions of care and chronic disease management initiatives
• Collaborate with clinical leaders to improve quality outcomes
• Manage CIN budgets, shared savings/loss models, and cost containment strategies
• Analyze utilization, cost trends, and financial performance
• Identify opportunities for savings while maintaining quality care
• Ensure compliance with CMS and other regulatory requirements
• Monitor quality metrics (e.g., HEDIS, CMS ACO measures)
• Lead quality improvement initiatives and reporting
• Utilize data analytics to drive decision-making and performance improvement
• Oversee reporting dashboards and performance tracking
• Translate data insights into actionable operational strategies
• Build strong relationships with physicians, hospitals, and network providers
• Support provider education on value-based care and CIN performance
• Collaborate with payers and external partners

Requirements

• Bachelor's Degree in Healthcare Administration, Business, Nursing, or related field required
• 7 or more years of healthcare experience
• Master's Degree MHA, MBA, MPH, or similar preferred
• 3 or more years in CIN, population health, or value-based care leadership
• Experience with CMS ACO programs (e.g., MSSP) preferred
• Strong knowledge of value-based care models and healthcare reimbursement
• Experience with healthcare analytics and performance metrics
• Excellent leadership, communication, and stakeholder management skills
• Financial acumen and strategic planning expertise
• Familiarity with EHR systems and population health platforms

Skills

• Strong knowledge of value-based care models and healthcare reimbursement
• Experience with healthcare analytics and performance metrics
• Excellent leadership, communication, and stakeholder management skills
• Financial acumen and strategic planning expertise
• Familiarity with EHR systems and population health platforms