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VHP Assistant Director, Managed Care Programs
Under direction, to direct the design, development and implementation of managed care systems of the County of Santa Clara's Knox-Keene licensed managed care organization, Valley Health Plan; to maintain internal relations with medical staff and administration, managers and other clinicians, and to develop and maintain relations with external potential health care providers, work groups and customer departments and agencies. This position is responsible for: 1) Provider Contracting; 2) Contract Configuration in VHP's Core System, QNXT; 3) Provider Credentialing; 4) Strategic Network Development; 5) Provider Data Management; 6) Value-based Contracting Strategies, including Pay-For-Performance; 7) Provider Relations; and 8) Provider Services.
Filing Period and Application Procedure
Final Filing Date: 5/8/2019. The recruitment may be extended or close as early as 10 days after issue date. You are encouraged to apply as soon as possible and to monitor this site for updated closing information.
This recruitment requires the submission of an online application. No paper applications will be accepted. Applicants must apply online at www.sccjobs.org. Computers are available at the County Government Center, 70 West Hedding Street, 8th Floor, East Wing, San Jose, CA 95110, during normal business hours, for applicants to apply online.
Completion of the Supplemental Questionnaire, Cover Letter and a Resume, is required.
Questions regarding this Executive recruitment may be directed to Alan Reed, Executive Services at (408) 299-5851.
•Provides leadership and directs the design and development and implementation of the managed care program;
•Directs activity of consultants, attorneys, and internal management information systems and managed care administrative and analyst staff;
•Develops and maintains cooperative relationships with internal administrative and medical staff members;
•Recommends to administration which services to provide or buy from external providers;
•Develops networks and maintains cooperative relations with potential providers and customer departments, businesses and agencies;
•Represents the department's interests before Federal, State, and local government agencies and community interest groups;
•Works with the management of public and mental health and alcohol program departments and hospital and clinics to develop and modify roles and missions so that they are congruent with managed care programs;
•Performs other related duties as required.
Possession of a bachelor's or higher degree in business administration, health care administration or a related field and substantial experience with health care delivery programs to acquire the knowledge and abilities listed below.
Experience Note: This position requires substantial managed care program or related experience where a high level of responsibility and accountability was held, preferably in programs dealing with Medicaid, a large geographic area, and variety of providers, a teaching hospital, and a public/political environment.
•Laws and regulations governing the development and operation of managed care programs;
•Business practices and operating customs peculiar to health care providers and networks;
•The nature and extent of political interests and considerations surrounding health care delivery;
•The potential affects of federal, state and local budgetary actions on managed care programs.
•Apply creativity, imagination and leadership to the development of programs;
•Assume a leadership role in gaining the cooperation of internal staff and external providers, customers, and community interests;
•Recognize and respond effectively to the political realities of the health care delivery environment;
•Recognize and meet customer needs and market considerations;
•Work cooperatively and effectively with all elements of the health care delivery system;
•Work effectively and react intelligently in a high charged, dynamic environment;
•Maintain focus on customer service, market share, and financial factors affecting programs.
County of Santa Clara
70 W. Hedding Street
8th Floor, East Wing
San Jose, California, 95110
Time: Full time
Updated: 3/29/2019 6:36:04 PM