Dir, Ipa Network Operations

Overview:

The Director of IPA Operations will lead the daily operational aspects of the IPA network, including managing network activities, developing plans to continually improve services to patients and enhance network performance, tracking KPIs and identifying areas of opportunity, and developing and maintaining strong relationships with IPA partners. This role will require collaboration with central departments to execute on strategic efforts and to ensure that any issues are resolved quickly and effectively. The IPA Director will be responsible for leading direct reports and managing their portfolios of projects. This position is also responsible for developing and managing new programs and processes to improve operational efficiency and performance as well as enhance the quality outcome for patients. The Director of IPA Operations will have visibility to and interaction with senior and executive leadership as well as the opportunity to create and drive critical operational and strategic initiatives.

Responsibilities:

1. Build and maintain relationships with internal teams and external stakeholders and serve as a key resource in driving IPA initiatives.
2. Assist VP with development and implementation of strategic and operational activities.
3. Lead, guide, and train direct reports (delegate work and clarify responsibilities, monitor day to day projects and priorities, complete performance reviews, develop and implement work plans to achieve goals).
4. Collaborate with internal teams to provide visibility into performance and proactively identify areas of opportunity that can improve provider engagement and patient outcomes.
5. Participate in JOMs with IPA partners (PCPs and specialists).
6. Manage and lead network initiatives including growth and retention, patient experience, risk adjustment, quality, access, and appropriateness of care.
7. Support Budget planning process as well as financial and operational performance objectives.
8. Develop and execute on strategies to ensure the provider network receives exceptional attention and customer care and is highly satisfied with our services.
9. Coordinate the development of qualitative and quantitative performance indicators to create dashboards that track project variances and impact.
10. Work closely with IPA leadership on day to day efforts and long-term strategies.
11. Perform additional ad hoc duties as assigned.

Qualifications:

1. Bachelor’s degree in Business Administration or Health Care Administration required.
2. Master’s degree in Health Care Administration is highly preferred.
3. Minimum of 7 years of experience working in a managed care health care environment, health plan, medical group, or provider office required.
4. Knowledge of: HEDIS, CAHPS, HOS, Hierarchical Condition Category (HCC), Risk Adjustment Factor (RAF) score, CPT and ICD coding systems.
5. Working Knowledge of: Eligibility, Claims, Credentialing and Utilization Management is preferred.