Vice President, Health Services

General Description Of Position

The Vice President, Health Services is responsible for optimizing the quality and value of health care received by health plan members by providing consistent, innovative leadership and direction to design, implementation, analysis, monitoring and reporting of effective and efficient health management services across all lines of business.

Essential Duties And Responsibilities

• Provides leadership, direction, and oversight to all of the Health Services areas (Case Management, Utilization Management, Quality Improvement, Behavioral Health, Pharmacy, Long Term Services and Supports, Process Improvement) and vendor(s) to ensure achievement of organizational, departmental and individual goals and maximize health outcomes for health plan members.
• Designs, implements and administers best practices to ensure health care quality and value is maximized at the plan through appropriate utilization of health care services and contracts and relationships with delegates and vendors.
• Assures effectiveness of departments by designing and monitoring key metrics to continuously improve outcomes, and take targeted actions when metrics indicate improvement is warranted.
• In conjunction with the Chief Medical Officer, develops and implements appropriate clinical policies and procedures and programs.
• Plans and prepares designated Committee meetings (Pharmacy and Therapeutics, Utilization Management, Quality Improvement).
• Operationalizes new benefits, pilots and existing programs such as Palliative Care, Dual Eligible Special Needs Plan (DSNP), CalAIM, Student Behavioral Health Incentive Program (SBHIP) and Housing and Homeless Incentive Program (HHIP) among others.
• Creates and reviews budgets of assigned departments as part of the annual planning and budgeting cycle and ongoing.
• Contributes to the development of strategic planning for short and long term health plan goal development in conjunction with integration of Health equity measures to decrease disparities.
• Develops innovative solutions to management and sharing of data needed for Health Services for operational and programmatic initiatives.
• Drives new health services initiatives and collaborations across departments to support continuous improvement and health plan goals.
• Instills a culture of Continuous Process Improvement, identify, design and implement Process Improvement opportunities, implement new systems required to support health services operations.
• Supports and builds cross-functional relationships with key partners across the organization.
• Motivates teams and individuals to achieve goals, while enforcing accountability.
• Safeguards ongoing audit readiness and compliance with regulatory requirements from Centers for Medicare and Medicaid Services (CMS), CA Department of Health Care Services (DHCS), CA Department of Managed Health Care (DMHC) and National Committee for Quality Assurance (NCQA).
• Supports and builds cross-functional relationships with key partners across the organization.
• Ensures ongoing audit readiness and compliance with regulatory requirements from Centers for Medicare and Medicaid Services (CMS), CA Department of Health Care Services (DHCS), CA Department of Managed Health Care (DMHC) and National Committee for Quality Assurance (NCQA).

Supervisory/Management Responsibilities

• Carries out supervisory/management responsibilities in accordance with the organization’s policies, procedures, applicable regulations and laws.
• Provides effective leadership to attract and retain top talent to drive business results, including recruiting, interviewing, and hiring.
• Develops a high performing division culture and staff. This includes setting the standard for staff/peers and motivating employees to maximize organizational goals and objectives.
• Effectively assimilates, trains and mentors staff and, when appropriate, cross trains existing staff and initiating retraining. This includes coaching to help increase skills, knowledge and (if applicable) improve performance.
• Assigns, and directs work consistent with said goals. This includes responding to employees’ needs, ensuring they have the necessary resources to do their work.
• Applies goals and plans, assigns, and directs work consistent with said goals. This includes responding to employees’ needs, ensuring they have the necessary resources to do their work.
• Applies goals and plans, assigns, and directs work consistent with said goals. This includes responding to employees’ needs, ensuring they have the necessary resources to do their work.
• Applies goals and plans, assigns, and directs work consistent with said goals. This includes responding to employees’ needs, ensuring they have the necessary resources to do their work.
• Applies goals and plans, assigns, and directs work consistent with said goals. This includes responding to employees’ needs, ensuring they have the necessary resources to do their work.
• Applies goals and plans, assigns, and directs work consistent with said goals. This includes responding to employees’ needs, ensuring they have the necessary resources to do their work.
• Applies goals and plans, assigns, and directs work consistent with said goals. This includes responding to employees’ needs, ensuring they have the necessary resources to do their work.
• Applies goals and plans, assigns, and directs work consistent with said goals. This includes responding to employees’ needs, ensuring they have the necessary resources to do their work.
• Applies goals and plans, assigns, and directs work consistent with said goals. This includes responding to employees’ needs, ensuring they have the necessary resources to do their work.
• Applies goals and plans, assigns, and directs work consistent with said goals. This includes responding to employees’ needs, ensuring they have the necessary resources to do their work.
• Applies goals and plans, assigns, and directs work consistent with said goals. This includes responding to employees’ needs, ensuring they have the necessary resources to do their work.
• Applies goals and plans, assigns, and directs work consistent with said goals. This includes responding to employees’ needs, ensuring they have the necessary resources to do their work.
• Applies goals and plans, assigns, and directs work consistent with said goals. This includes responding to employees’ needs, ensuring they have the necessary resources to do their work.
• Applies goals and plans, assigns, and directs work consistent with said goals. This includes responding to employees’ needs, ensuring they have the necessary resources to do their work.
• Applies goals and plans, assigns, and directs work consistent with said goals. This includes responding to employees’ needs, ensuring they have the necessary resources to do their work.
• Applies goals and plans, assigns, and directs work consistent with said goals. This includes responding to employees’ needs, ensuring they have the necessary resources to do their work.
• Applies goals and plans, assigns, and directs work consistent with said goals. This includes responding to employees’ needs, ensuring they have the necessary resources to do their work.
• Applies goals and plans, assigns, and directs work consistent with said goals. This includes responding to employees’ needs, ensuring they have the necessary resources to do their work.
• Applies goals and plans, assigns, and directs work consistent with said goals. This includes responding to employees’ needs, ensuring they have the necessary resources to do their work.
• Applies goals and plans, assigns, and directs work consistent with said goals. This includes responding to employees’ needs, ensuring they have the necessary resources to do their work.
• Applies goals and plans, assigns, and directs work consistent with said goals. This includes responding to employees’ needs, ensuring they have the necessary resources to do their work.
• Applies goals and plans, assigns, and directs work consistent with said goals. This includes responding to employees’ needs, ensuring they have the necessary resources to do their work.
• Applies goals and plans, assigns, and directs work consistent with said goals. This includes responding to employees’ needs, ensuring they have the necessary resources to do their work.
• Applies goals and plans, assigns, and directs work consistent with said goals. This includes responding to employees’ needs, ensuring they have the necessary resources to do their work.
• Applies goals and plans, assigns, and directs work consistent with said goals. This includes responding to employees’ needs, ensuring they have the necessary resources to do their work.
• Applies goals and plans, assigns, and directs work consistent with said goals. This includes responding to employees’ needs, ensuring they have the necessary resources to do their work.
• Applies goals and plans, assigns, and directs work consistent with said goals. This includes responding to employees’ needs, ensuring they have the necessary resources to do their work.
• Applies goals and plans, assigns, and directs work consistent with said goals. This includes responding to employees’ needs, ensuring they have the necessary resources to do their work.
• Applies goals and plans, assigns, and directs work consistent with said goals. This includes responding to employees’ needs, ensuring they have the necessary resources to do their work.
• Applies goals and plans, assigns, and directs work consistent with said goals. This includes responding to employees’ needs, ensuring they have the necessary resources to do their work.
• Applies goals and plans, assigns, and directs work consistent with said goals. This includes responding to employees’ needs, ensuring they have the necessary resources to do their work.
• Applies goals and plans, assigns, and directs work consistent with said goals. This includes responding to employees’ needs, ensuring they have the necessary resources to do their work.
• Applies goals and plans, assigns, and directs work consistent with said goals. This includes responding to employees’ needs, ensuring they have the necessary resources to do their work.
• Applies goals and plans, assigns, and directs work consistent with said goals. This includes responding to employees’ needs, ensuring they have the necessary resources to do their work.
• Applies goals and plans, assigns, and directs work consistent with said goals. This includes responding to employees’ needs, ensuring they have the necessary resources to do their work.
• Applies goals and plans, assigns, and directs work consistent with said goals. This includes responding to employees’ needs, ensuring they have the necessary resources to do their work.
• Applies goals and plans, assigns, and directs work consistent with said goals. This includes responding to employees’ needs, ensuring they have the necessary resources to do their work.
• Applies goals and plans, assigns, and directs work consistent with said goals. This includes responding to employees’ needs, ensuring they have the necessary resources to do their work.
• Applies goals and plans, assigns, and directs work consistent with said goals. This includes responding to employees’ needs, ensuring they have the necessary resources to do their work.
• Applies goals and plans, assigns, and directs work consistent with said goals. This includes responding to employees’ needs, ensuring they have the necessary resources to do their work.
• Applies goals and plans, assigns, and directs work consistent with said goals. This includes responding to employees’ needs, ensuring they have the necessary resources to do their work.
• Applies goals and plans, assigns, and directs work consistent with said goals. This includes responding to employees’ needs, ensuring they have the necessary resources to do their work.
• Applies goals and plans, assigns, and directs work consistent with said goals. This includes responding to employees’ needs, ensuring they have the necessary resources to do their work.
• Applies goals and plans, assigns, and directs work consistent with said goals. This includes responding to employees’ needs, ensuring they have the necessary resources to do their work.
• Applies goals and plans, assigns, and directs work consistent with said goals. This includes responding to employees’ needs, ensuring they have the necessary resources to do their work.
• Applies goals and plans, assigns, and directs work consistent with said goals. This includes responding to employees’ needs, ensuring they have the necessary resources to do their work.
• Applies goals and plans, assigns, and directs work consistent with said goals. This includes responding to employees’ needs, ensuring they have the necessary resources