7 days old

Kidney Care Program Director

Independence Blue Cross LLC
Philadelphia, PA 19107
  • Job Code
    200427

Job
Purpose:



The Director, Kidney Care Programs is responsible for creating,
implementing and leading a transformational population health program designed
to engage members with renal disease and the network providers treating them, enable
the delivery of more integrated healthcare services, and generate value by
improving clinical outcomes and facilitating a better member experience. The position is accountable for vendor
oversight, directing network engagement, program administration and related
results in Pennsylvania and New Jersey for both the Medicare Advantage and
Commercial markets. This position will
work collaboratively with Independence leadership across multiple stakeholder
areas to ensure achievement of program goals and promote best in class
performance with respect to the delivery of value-based kidney care.





Major
Accountabilities:




  • Oversees a population health vendor tasked with
    supporting the care journey for members with renal disease. Ensures robust vendor relationships are
    developed, effective communication channels are maintained, vendor-led
    activities are aligned with broader Independence goals (e.g. clinical
    excellence, member experience, provider collaboration) and vendor-led programs deliver
    expected results. To this end:
  • Oversees contract negotiations, including the
    definition of service level agreements and the development/implementation
    of reimbursement strategies designed to drive best in class vendor support.
  • Ensures ongoing vendor performance
    monitoring strategies are established, utilizing vendor performance
    dashboards, scorecards or other reports to promote the necessary
    transparency across key stakeholders.
  • Also ensures performance improvement and
    recovery plans are developed, issued, and tracked and managed, as
    appropriate.
  • Communicates strategic direction to team
    to support planning, prioritization, resource allocation and general decision
    making.
  • Delineates areas of accountability and
    performance expectations.
  • Coaches, mentors and evaluates direct
    reports and other associates.
  • Identifies performance gaps as well as
    gaps in individual and team skill sets required to support the achievement
    of kidney care goals and objectives.
  • Addresses these gaps through selective
    hiring, provision of developmental opportunities and, as appropriate,
    implementation of redeployment and exit strategies.
  • Monitors and intervenes to ensure that
    team has adequate bench strength, and that succession plans are
    developed and effectively executed for key positions within the team.
  • Creates a team culture and sets expectations
    around behavior that foster and support Independences Mission, Vision and
    Core Values.
  • Plans and oversees the activities of direct
    reports tasked with engaging network providers to ensure that work efforts are
    geared toward 1) supporting the identification and promulgation of best
    practices in renal care delivery and 2) identifying and addressing
    opportunities to improve outcomes at both the individual provider and network
    level.
    In support of ongoing network
    engagement and performance improvement, also works cross-functionally to drive
    the development, implementation, communication and management of provider performance
    metrics.
    Establishes shared savings and
    other provider-focused incentive programs designed to optimize outcomes.
  • Works with direct reports and cross-functionally
    to ensure that key capabilities are developed and maintained in support of
    established goals and objectives.
    These
    capabilities include but are not limited to data analysis, process analysis,
    vendor and ROI evaluations and project management techniques.
    Deploys these capabilities and proactively
    collaborates with key functional areas (e.g. HVO, Medical Affairs, Provider
    Contracting & Reimbursement, IX, Actuarial, P&Ls, Legal, Compliance and
    Operations) to assess and vet ongoing program activities, proposed program
    enhancements, prevent and resolve problems, and support initiatives designed to
    improve performance for key metrics associated with the program.
  • Supports the development of CCTs long-term
    strategy and vision within the context of FHN-specific and broader Independence
    strategy, goals and objectives.
  • Hires and maintains qualified staff
  • Performs other duties as assigned.



QUALIFICATIONS:




The candidate must have a bachelors degree
(Masters or above preferred) or equivalent work experience. Minimum 5
years supervisory/management experience and 7-10 years experience in
increasingly complex assignments focused on provider relations, vendor
management and/or population health. Prior experience related to renal
care delivery required.



The candidate must have excellent leadership,
interpersonal and communication skills. The candidate must also have excellent organizational and analytical
skills and a strong internal and external customer focus. The candidate must be able to identify,
recruit, retain and develop management-level staff; develop positive working
relationship with senior (direct and above) level staff in other functional
areas and adapt quickly and easily to a rapidly changing business
environment.



A trained nephrologist with above skills would
be preferred, though strong candidates without clinical backgrounds will be
considered as well.









Posted: 2020-06-29 Expires: 2020-07-28
Sponsored by:
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Sponsored by:
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Kidney Care Program Director

Independence Blue Cross LLC
Philadelphia, PA 19107

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