Director-Accountable Care & Physician Clinical Integration Network

J  o  b    D  e  s  c  r  i  p  t  i  o  n

          Joy                         Care                      Competence                    Respect

Position Summary

The Director–Accountable Care & Physician Clinical Integration Network (PCIN) will lead key initiatives to enhance the system's strategic positioning and operational efficiency. This pivotal role involves overseeing governance structures, managing financial aspects, and strategically recruiting independent physicians in alignment with market and system strategic goals. The position plays a central role in negotiating and implementing fee-for-service and value-based contracts, while also providing visionary leadership to maintain Clinical Integration Network (CIN) market position. Responsible for optimizing operational practices, ensuring compliance with government programs, and chairing the Finance Committee for HSHS ACO and PCIN.

Bachelor's degree in Healthcare Administration, Business Administration, Public Health, or a related field is required.

Master's degree in Healthcare Administration, Business Administration, Public Health, or a related field is preferred.

3 years experience in healthcare operations, governance, and management roles which may include leadership roles within healthcare organizations, clinical integration networks, or accountable care organizations is required.

3 years of progressively more responsible leadership experience is required.

N/A

Understanding of healthcare delivery systems, regulatory compliance, and industry trends.

Familiarity with governance structures, policies, and procedures within healthcare organizations.

Knowledge of healthcare reimbursement models and financial implications of value-based contracts.

Understanding of physician recruitment strategies and engagement practices.

Critical thinking and problem-solving skills to navigate complex healthcare environments.

Excellent communication skills to facilitate effective collaboration with internal and external stakeholders.

Cultivate and maintain strong relationships with independent physicians in both large and small group practices. Collaborate with physicians to understand their needs and concerns, addressing issues promptly. Facilitate communication channels between physicians and the clinical integration network.

Conduct strategic analyses to identify gaps in the current physician network based on specialty, geographic coverage, and patient needs in alignment with market and system strategic plan. Collaborate with internal stakeholders and data analytics teams to determine target recruitment areas and specialties. Develop and implement outreach strategies to engage potential physicians in discussions about joining the CIN. Highlight the benefits of collaboration, including access to a broader patient base, shared resources, and opportunities for professional development.

Develop and oversee governance structures and processes for effective decision-making within PCIN and HSHS ACO, LLC. Facilitate regular meetings with key stakeholders to ensure alignment with strategic goals and compliance with regulatory requirements.

Lead and facilitate the Finance Committee, ensuring robust discussions and informed decision-making. Manage and supervise the accurate and timely distribution of earnings resulting from value-based contracts. Collaborate with finance and accounting teams to ensure precise calculations and adherence to contractual terms. Address any discrepancies or issues related to earnings distribution promptly and in accordance with contractual obligations.

In collaboration with the System Director, and Vice President of Managed Care, lead discussions and negotiations with payers to establish fee-for-service and value-based contracts. Collaborate with cross-functional teams to develop and implement contract strategies that align with the system’s financial objectives. Regularly assess the performance of existing contracts and initiate discussions for contract enhancements or modifications.

In collaboration with the System Director, and Vice President of Managed Care, provides leadership, direction and oversight to maintain and improve the market position of the clinical integration network; Foster relationships with other Clinical Integration Networks (CINs) to promote collaboration and knowledge exchange as needed.

Oversee vendor relationships and contract management, ensuring the delivery of high-quality services. Manage contracted provider payouts, ensuring accuracy and timeliness. Implement operational best practices to optimize the efficiency of PCIN and HSHS ACO, LLC operations.

Administration oversight of government programs to include MSSP. Stay informed about regulatory changes and ensure compliance with evolving healthcare policies. 

Develop and manage budgets for the PCIN and HSHS ACO, LLC., ensuring financial sustainability and adherence to fiscal targets. Conduct regular financial analyses to identify areas for cost optimization and revenue enhancement. Collaborate with finance teams to provide accurate and timely financial reporting.

Leads a team of colleagues in human resource initiatives including but not limited to; performance management; education and development; selection and retention; workforce planning; coaching and counseling; and supporting activities that promote colleague engagement and satisfaction. 

Leads or supports the financial resource functions including but not limited to; managing expenses; preparing, monitoring and executing within limits of the budget; monitors productivity standards; manages the purchasing process and all decisions related to the finances for the area of responsibility. 

Leads or supports change and process improvement initiatives including but not limited to; strives for standard, efficient and value-added processes; communicates a clear vision; influences and motivates others; and develops strong relationships with key stakeholders. 

The purpose of this job description is to provide a summary of the major responsibilities performed by colleagues in this position. Colleagues may be requested to perform tasks other than those specifically presented in this job description.  Variances in job duties performed may exist between facilities, and colleagues may perform other related duties as assigned to meet the needs of the organization.

PHYSICAL, MENTAL AND ENVIRONMENTAL REQUIREMENTS

Physical, Mental and Environmental Requirements Category:

Leadership

Standing

X

Walking

X

Sitting

X

Lifting

X

20 lbs.

Carrying

X

20 lbs.

Pushing

X

20 lbs.

Pulling

X

20 lbs.

Climbing

X

Balancing

X

Stooping

X

Kneeling

X

Crouching

X

Crawling

X

Reaching

X

Use of Hands/Dexterity

X

Talking

X

Hearing

X

Eye/Hand/Foot Coordination

X

Extreme cold

X

Extreme heat

X

Humid

X

Wet

X

Noise

X

Hazards

X

Temperature Change

X

Atmospheric Conditions

X

Vibration

X

Other

X