VP of Operations

Universal Health Services; Reno (NV); On-site; USD 210,000 - 280,000; Full time

Benefits offered by this job

Loan Forgiveness Program

Competitive Compensation & Generous PT

Excellent Medical, Dental, Vision and

401(K) with company match and discount

SoFi Student Loan Refinancing Program

Career development opportunities

Job summary

Universal Health Services, through Prominence Health, seeks a Vice President of Operations to lead a comprehensive operations portfolio and drive efficiency across Enrollment, Claims, Configuration and Customer Service. You will oversee Medicare Advantage, Commercial and ASO/Self-Funded programs while partnering with UHS workgroups on population management and clinical integration initiatives.

As a member of the senior leadership team, you will shape strategic plans, manage performance, and

Qualifications

• Bachelor's degree in Business or related Healthcare field; Master's degree preferred.
• At least eight years in Operations management or consulting with three years in managed care.
• Experience with revenue cycle optimization and provider contracts.

Responsibilities

• Lead and manage Prominence Operations aligned to strategic goals.
• Direct responsibility for Enrollment, Claims, Configuration and Customer Service.
• Oversee all current and future lines of business including Medicare Advantage, Commercial and ASO/Self-Funded.
• Serve on Prominence senior leadership and collaborate with UHS workgroups on population management.

Skills

Strong communication

Relationship building

Strategic thinker

Leadership

Change management

Education

Bachelor's Degree in Business or related Health Care degree

Master's in Public Health or MBA

Tools

Microsoft Office Suite

Job description

Responsibilities

Prominence Health is a value-based care organization bridging the gap between affiliated health systems and independent providers, building trust and collaboration between the two. Prominence Health creates value for populations and providers to strengthen integrated partnership, advance market opportunities, and improve outcomes for our patients and members. Founded in 1993, Prominence Health started as a health maintenance organization (HMO) and was acquired by a subsidiary of Universal Health Services, Inc. (UHS) in 2014. Prominence Health serves members, physicians, and health systems across Medicare, Medicare Advantage, Accountable Care Organizations, and commercial payer partnerships. Prominence Health is committed to transforming healthcare delivery by improving health outcomes while controlling costs and enhancing the patient experience.

Learn more at: https://prominence-health.com/

Job Summary:

The Vice President of Operations leads and manages Prominence's Operations consistent with the strategic goals of Prominence Health. This position is a key part of Prominence's strategic imperative to achieve its financial performance goals, as well as its goal of building the capacity necessary to support UHS's clinical integration strategy. The incumbent will take direct responsibility for Prominence Operations with Enrollment, Claims, Configuration, and Customer Service. The incumbent will be responsible for all current lines of business and future lines of business including Medicare Advantage, Commercial, and ASO/Self-Funded. As a member of Prominence's senior leadership team, the incumbent will be accountable with other senior leaders for achieving Prominence's financial, quality, and service goals. In addition, the incumbent will represent Prominence in UHS workgroups working on clinical integration and population management.

Benefit Highlights:

• Loan Forgiveness Program
• Challenging and rewarding work environment
• Competitive Compensation & Generous Paid Time Off
• Excellent Medical, Dental, Vision and Prescription Drug Plans
• 401(K) with company match and discounted stock plan
• SoFi Student Loan Refinancing Program
• Career development opportunities within UHS and its 300+ Subsidiaries! * More information is available on our Benefits Guest Website: benefits.uhsguest.com

About Universal Health Services:

One of the nation's largest and most respected providers of hospital and healthcare services, Universal Health Services, Inc. (UHS) has built an impressive record of achievement and performance. During the year, UHS was again recognized as one of the World's Most Admired Companies by Fortune; and listed in Forbes ranking of America's Largest Public Companies. Operating acute care hospitals, behavioral health facilities, outpatient facilities and ambulatory care access points, an insurance offering, a physician network and various related services located all over the U.S. States, Washington, D.C., Puerto Rico and the United Kingdom. www.uhs.com

Qualifications

Qualifications and Requirements:

Education and Experience:

• Bachelor's Degree in Business or related Health Care degree, and Master's in Public Health or MBA.
• At least eight years of Operations management or consulting experience with at least three year experience in managed care.

Commercial specific:

• Experience with optimizing revenue cycle from rate development to billing and collection
• Experience with optimizing benefit administration cycle from benefit design to provider contracts and claims
• Experience with provider networks from reimbursement models (including P4P and capitation) to contracting and their impact on operations

Third Party Administration specific:

• Experience with self-funded groups from benefit design to reinsurance contracts to client reports

Medicare Advantage specific:

• Experience with multi-State Medicare Advantage program
• Experience with CMS at the strategic and tactical level
• Experience with delegated entities
• Strong coordination capabilities to direct and supervise the intersections of Prominence functional areas and delegated entities
• Capability to build in-house infrastructure to allow outsourced functions being moved in-house
• Experience to work collaboratively with Compliance
• Detailed understanding of the bid submission process
• Detailed understanding of the risk score collection and documentation process
• Detailed understanding of the Star rating process and demonstrated ability to move Plan toward a 5-star rating

Skills:

• Strong communication, influencing, presentation, and relationship building skills
• Proficient in Microsoft Office Suite
• Strategic but practical thinker that can take concepts from its initial stage through implementation to administration
• Excellent communicator who is equally comfortable with external stakeholders as well as internal stakeholders
• Demonstrated ability to build a highly functioning team and to mentor direct reports
• Experience with Commercial, Self-funded, and Medicare Advantage network requirements
• Proven ability to foster collaboration between divergent stakeholders
• High degree of credibility with key stakeholders based on past accomplishments
• Experience in negotiating complex provider reimbursement arrangement and complex third party contracts
• Adept in managing outsourced vendor relationships in compliance with NCQA and CMS delegated entity rules
• Comfortable in managing interfaces with Prominence functional areas and third party partners
• Proven ability to drive organization through cultural change, focused on individual accountability and performance
• Solid understanding of health plan key financial drivers
• Service excellence orientation toward external and internal stakeholders

EEO Statement

All UHS subsidiaries are committed to providing an environment of mutual respect where equal employment opportunities are available to all applicants and teammates. UHS subsidiaries are equal opportunity employers and as such, openly support and fully commit to recruitment, selection, placement, promotion and compensation of individuals without regard to race, color, religion, age, sex (including pregnancy, gender identity, and sexual orientation), genetic information, national origin, disability status, protected veteran status or any other characteristic protected by federal, state or local laws.

We believe that diversity and inclusion among our teammates is critical to our success.