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Vice President of MSO Operations

Company: Kinsley Power Systems
Location: Orange
Posted on: September 21, 2022

Job Description:

Vice President of IPA Operations
Prospect Medical Systems
Reporting: Chief Operations Officer, Prospect Medical Systems
Seated: California Remote, with occasional travel to Orange CA.
Required to reside in Central/Mountain/PST time zone and willing to work PST business hours
Job Summary:
Develops and leads company's operational policies, objectives and initiatives to support ongoing national growth for all product lines (including Medicare, Medicaid, Commercial, Exchange), risk models (value-based care, professional risk, global risk) and delegation levels. Creates and executes strategies to attain short- and long-term financial and mission-critical operational goals, while ensuring compliance with federal, state and health plan regulations/policies. Utilization of continuous process improvement techniques and technology solutions will be key to successfully delivering on quality and productivity goals.

  • Provides leadership and direction for key operations departments & functions, to include Claims Payment; System Configuration for contracts/benefits/DOFRs; Encounter Data; Customer Service; Credentialing and Provider Data Management.
  • Ensures department & staff goals are established & monitored to drive company goal achievement annually. Includes oversight of external vendors, as well as internal staff. Presents periodic performance reports and metrics to the chief operating officer and other leadership.
  • Maintains working knowledge of healthcare regulations and health plan policies to ensure compliance for all lines of business (Medicare, Medicaid, Commercial, Exchange) and in all operating states. Monitors regulatory and health plan audit results to identify and address any adverse trends. In addition, establishes and monitors internal quality assurance audit processes as a part of continued operational improvements.
  • Provides leadership, mentoring and management to departments to ensure adequate, ongoing training & quality assurance; goal attainment; and ongoing elevation of individual skill sets. Ensures teams' compliance with regulatory, health plan and company policies & procedures and strategic use of tools and reports. Develops metrics and tools to measure/affect progress on company, team and individual goals, monitoring & implementing new/revised action plans as warranted. Includes management to budget.
  • Collaborates with Executive Team and key business units to identify, evaluate and implement data automation and process improvements.
  • Supplies operational expertise and guidance on potential acquisitions, projects and systems.
  • Collaborates with other divisions and departments to carry out the organization's goals and objectives.

    Job Knowledge, Skills, and Abilities:
    To perform this job successfully, an individual must be able to perform the job description satisfactorily. This job description reflects management's assignment of essential functions; it does not prescribe or restrict the tasks that may be assigned. The requirements listed below are representative of the knowledge, skill, and ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

    • Excellent verbal and written communication skills.
    • Strong supervisory and leadership skills.
    • Extensive knowledge of the principles, procedures, and best practices in the industry.
    • Excellent organizational skills and attention to detail.
    • Strong analytical and problem-solving skills.
    • Proficient with Microsoft Office Suite.

      Required Education/Experience:

      • Bachelor's degree in Business Administration, Healthcare Management or other industry-related field required.
      • At least 10 years of industry-related experience including three years in upper management required.

        Preferred Education/Experience:

        • MBA preferred.

          Enterprise Profile
          Established in 1996, Prospect Medical Holdings, Inc. has grown into a significant provider of coordinated regional healthcare services in Southern California, Connecticut, Pennsylvania, Rhode Island, Arizona and South Central Texas.
          Prospect Medical Holdings, Inc. has grown to over 20,000 employees, 17 acute care and behavioral hospitals, over 600,000 members and includes a network of over 6,600 doctors and specialists.
          Prospect Medical is a family of mission-focused healthcare professionals offering hospital and community-based health services. In partnership with our physicians, our hospitals and affiliated medical groups are committed to high-quality healthcare services tailored to the unique needs of the communities we serve.
          Company Profile
          With over 6,600 primary care and specialist physicians to serve our 600,000 members, Prospect Medical Systems is proud to be among the most innovative medical systems in 6 states: California, Texas, Rhode Island, Arizona, Pennsylvania, and Connecticut. Locations in California include Los Angeles, Orange County, Riverside County, San Diego, and San Bernardino County. Our extensive care services range from primary care and specialty physician services to acute care hospitals and skilled nursing facilities to behavioral health and wellness services.
          Each of our Independent Physician Associations (IPAs) and networks support the use of advanced diagnostic and treatment tools to provide our members with convenient access to state-of-the-art healthcare. Prospect Medical Systems currently manages 20 IPAs and networks - contracts with all major health plans and has a successful track record of growth, cost management, and outcome achievement.
          Job Location Profile
          This role is 100% remote.
          Our main office is located at 600 City Pkwy West in Orange, CA. Prospect Medical Systems houses employees from across the enterprise at this location, as well as several hotel offices and cubicles for our local remote employees. We are conveniently located near the Outlets of Orange and are accessible from the 5, 22, and 57 freeways for an easy commute. This location is near dining options and offers free on-site parking. Our other office locations include Rancho Cucamonga, CA, and San Antonio, TX as well!

Keywords: Kinsley Power Systems, Orange , Vice President of MSO Operations, Executive , Orange, California

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