Vice President, Contract Operations

DaVita Medical Group - El Segundo, CA

Full-time | Temporary | Contract
The Vice President of Contract Operations is responsible for ensuring that all provider contracts (PCP, Specialist, Hospital, and Ancillary) are accurately and efficiently maintained within internal and external (health plan, regulator) systems. This individual leads 30+ full time and temporary teammates of varying skill levels in contract lifecycle management, analyzing current processes and monitoring performance, so as to develop strategic initiatives aimed at increasing throughput and improving data accuracy and completeness. This role is challenged with creating and implementing a comprehensive plan for identifying and resolving historical issues resulting from faulty data integration efforts, and building processes that prevent recurrence in the future. In achieving all of these objectives, the Vice President of Contract Operations ensures compliance with SB137, CMS, DMHC, and DHCS regulations, while at the same time maximizing Operations, Business Development, Marketing, provider, and patient satisfaction.

This role currently leads Contract Operations for HealthCare Partners in CA only, but there is potential for expanding the sphere of influence to include new groups and/or geographies in the future. This is a primarily office based role (at least 3 days in the office or field each week) housed in HealthCare Partners’ beautiful CA headquarters in El Segundo, CA.

The Vice President of Contract Operations will lead a team that utilizes the following programs, some of which are commercially available, and others of which are homegrown:

Apollo (Salesforce)
Visual Cactus
Gaine Sanator Portal

Knowledge, Abilities, and Skills:
Ability to analyze problems involving big data and a multitude of variables, develop concise strategic plans for addressing them, present these plans to leadership, report on progress, and meet deadlines
Ability to develop team reporting metrics and track performance, setting goals, and actively managing performance where needed
Ability to understand complex processes and interconnected systems, identifying opportunities for automation, and developing plans to initiate these efficiencies
Knowledge of provider network data requirements and regulations (DMHC, CMS, SB137, DHCS, health plan, etc.)
Knowledge of health plan provider directory management processes
Knowledge of provider contracting, credentialing, and health plan submission processes
Knowledge of different contracting arrangements (employed, IPA, downstream, capitated, FFS, shared risk, dual/full risk, global risk, etc.)
Strong project management abilities
Strong organizational skills
Ability to lead and persuade other teams and organizations
Ability to build strong relationships with payors and internal customers in order to achieve favorable outcomes for the organization and department
Knowledge of industry best practices for contract lifecycle management
Ability to conduct requirements and solution design workshops with business stakeholders
Experience authoring solution design and configuration specification deliverables
Experience with contract management systems
Strong Excel skills
Experience working with SQL, or SQL programmers
Strong written and verbal communication skills, especially when it comes to requesting reports (specifications, variable inclusion/exclusion, etc.)
Experience working with software vendors and conducting RFPs
Excellent presentation skills (PowerPoint, Word, Excel, etc.)

Bachelor’s degree

5+ years of management experience
Contracting lifecycle management experience
Project management and system implementation experience