TITLE: Executive Director, Clinically Integrated Network                                

SUPERVISOR: CIO TACHC

DEPARTMENT: Executive                

FLSA STATUS: Exempt                     

JOB SUMMARY

The Executive Director of the Clinically Integrated Network provides oversight, development and operational support of the TACHC clinically integrated network (CIN), and develops strong business relationships with participating health centers and internal business partners leading to the achievement of quality, provider satisfaction, medical cost, network growth, and efficiency targets. The Executive Director will partner with the CIN Board of Directors and the CIN leadership team in setting strategic priorities and goals for the CIN. The Executive Director will provide leadership and accountability for budgeting and fiscal management, manage department operations, establish the department’s administrative organizational structure and environment, has oversight for administrative policies and procedures within the organization, and is responsible for the recruitment, leadership, and development of other CIN staff. The Executive Director will work with the CIN Medical Director and other participating health center leaders to strategically align and integrate CIN goals and activities to achieve success under value-based arrangements.

The Executive Director is responsible for network development and provider relations, provider enrollment with payers, the CIN credentialing program, processes related to administering payor contracts, medical management functions – including care management, care coordination, disease management programs, clinical integration and quality improvement across the CIN provider network, and data analysis and reporting.

DUTIES & RESPONSIBILITIES

• Reports to the TACHC CIO in the operations and strategic planning of the CIN as it relates to budget planning, fiscal and resource planning/administration, human resources, contracting, vendor management and coordination, and negotiation of activities with other entities.
• Provides strategic leadership, oversight, and management over all aspects of the day-to-day administration of the CIN.
• Directs short and long-term strategic business plans for the CIN.
• Monitors and reports performance relative to stated goals and communicates and manages variances from the plan.
• Ensures efficient operations of CIN programs and initiatives through management and tracking of performance against Board-approved goals.
• Negotiates and executes value-based contracts with support of the CIO, CIN Attorney and Managed Care Contracting Team.
• Oversees implementation of value-based arrangements and educates CIN participants and their administrators on financial arrangements including shared risk and gain-share agreements and achievement of performance-based incentive programs.
• Serves as Chief of Staff for all CIN employees.
• Maintains a proactive approach to identifying opportunities/threats and creates solutions to navigate complex scenarios to ensure long term success of the CIN.
• Provides subject matter expertise on all matters pertaining to clinical integration.
• Oversees the development and implementation of quality and safety goals, in addition to the growth of the participant network in coordination with the Medical Director.
• Oversees completion of the annual CIN tax return and financial reviews.
• Manages the CIN Board of Directors and various CIN committees, including Finance/Operations and Quality Committees.
• Reports to the Board of Directors on program management and committee activities.
• Develops and directs processes and operations designed to meet the short and long-term utilization and other medical management targets established by the CIN Board of Directors.
•  In conjunction with the CIO, represents the CIN at local, regional, and national level workgroups and events.
• In coordination with TACHC staff and alignment with TACHC policies and procedures, manages vendor partnerships and subcontracting and maintains required regulatory reports; ensures timely filing of necessary applications for CIN insurance coverage.
• In coordination with TACHC staff and alignment with TACHC policies and procedures, directs all marketing and communication with CIN members, network providers, and potential new providers.
• In coordination with TACHC staff and alignment with TACHC policies and procedures, manages aggregation of clinical data and ongoing maintenance of data feeds across all network providers.

KNOWLEDGE, SKILLS, & ABILITIES

• Demonstrated understanding of the management issues in a highly complex environment and ability to provide initiative, judgment, and creativity in the resolution of complex problems.
• Demonstrated ability to identify and analyze all pertinent information/data to make and effectively communicate decisions to meet the CIN’s current and future needs.
• Effective communication and presentation skills and demonstrated track record of forming collaborative and effective working relationships with medical providers and administrative leaders.
• Demonstrated ability to manage and lead staff in a changing environment.
• Ability to establish realistic and achievable priorities and the ability to lead staff to achieve departmental goals and objectives.
• Demonstrated ability to negotiate value-based contracts and conduct financial analyses. 

CREDENTIALS & EXPERIENCE

Required

• Master’s degree in Business Administration, Healthcare Administration, or closely related field.
• A minimum of 7 years of progressive responsibility at a managerial level, preferably in an accountable care organization or healthcare setting.

Preferred

• Experience working with Federally Qualified Health Centers.
• Experience working with a statewide or multi-regional provider network.
• Experience working directly with and reporting to a board of directors.

PHYSICAL REQUIREMENTS

Position may require sitting for extended periods of time. Circumstances may require standing, walking, stretching, reaching, pushing, lifting objects weighing 10-30 pounds, bending, and/or stooping and the ability to safely and successfully perform the essential job functions.