Vice President, Health Plan Strategy and Managed Care, Chief Contracting Officer

Vice President, Health Plan Strategy and Managed Care, Chief Contracting Officer

Health Plan Strategy & Contracting

Full Time

85991BR

Job Summary

The Vice President, Health Plan Strategy & Managed Care & Chief Contracting Officer (CCO), UCSF Health establishes strategies for developing the financial, programmatic and operational long term plans for managed care and health plan partnerships, and strategic program and coverage expansion activities for the health system. Oversees negotiations of substantial importance and impact across the health system. This position will report directly to the SVP and Chief Financial Officer of UCSF Health. The VP / CCO is a member of UCSF Health's Senior Leadership Council (SLC) and a member of the System CFO's senior leadership team.

The position is directly responsible for negotiation and management of all UCSF Health's contracted payer relationships (commercial, governmental and large at-risk referring medical groups), as well as for developing contracting strategies to engage community providers and expand UCSF Health's growing regional footprint. This includes the increasingly important Community Integrated (physician) Network and regional hospital affiliations. Contracted entities include UCSF Medical Center, including Benioff Children's Hospital San Francisco, Benioff Children's Hospital Oakland, UCSF's School of Medicine (SOM) Faculty Practice Organization, including UCSF's rapidly expanding Clinically Integrated Network (CIN) - representing integrated community physicians in the greater bay area, as well as contracted UBCP physicians supporting BCHO, and for UCSF's Langley Porter Psychiatric Hospital.

In addition to overall contracting responsibility, the position is responsible for developing and executing managed care contracting strategy for commercial and governmental transplant Center of Excellence (COE) contracts, risk-bearing Accountable Care Organization (ACO) collaborations, and Health Insurance Exchange (HIE) products. Most importantly, the VP is responsible for ensuring commercial, Medicare Advantage seniors and Medi-Cal Managed Care plan enrollees can access UCSF from both local and regional markets. The role is responsible for all contract modeling, financial performance assessment and negotiation support (business, legal and financial), including EPIC-based calculation of expected payments and for monitoring actual contract payments / compliance.

In support of UCSF's rapidly expanding high value system of care and the Canopy Health network, this position works closely with UCSF's office of Population Health and UCSF's dyad partners to evaluate and improve the cost effectiveness of care delivery both for assigned and referred enrollees. This ensures contracting strategies are aligned with and actively support the achievement of optimal patient care, and will help to ensure the long term viability of UCSF Health.

The position will also play a critical role in in the execution of the UCSF Clinical Enterprise Plan which is a 5-year plan that is currently being updated for roll out in the winter of 2025, this plan will take us through the new opening of the new inpatient facilities expected in 2030 and 31.

The final salary and offer components are subject to additional approvals based on UC policy.

Your placement within the salary range is dependent on a number of factors including your work experience and internal equity within this position classification at UCSF. For positions that are represented by a labor union, placement within the salary range will be guided by the rules in the collective bargaining agreement.

The salary range for this position is $281,700 - $593,100 (Annual Rate).

To learn more about the benefits of working at UCSF, including total compensation, please visit : https : / / ucnet.universityofcalifornia.edu / compensation-and-benefits / index.html

Department Description

UCSF Health's department of Health Plan Strategy & Contracting provides strategic leadership and direction for all health plan and managed care contracting strategy. This includes execution and performance monitoring for UCSF Medical Center, including Benioff Children's Hospital San Francisco, UCSF's School of Medicine Faculty Practice Organization (FPO) and CIN, and for Benioff Children's Hospital Oakland, including its BCP medical foundation, and the Langley Porter Psychiatric Hospital.

Required Qualifications

• Master's degree in related area and / or equivalent experience / training.
• 10 years of experience as a leader in health plan strategy or related experience in the healthcare industry
• Exceptional ability to translate highly technical knowledge of contracting theory and Managed Care industry trends, into the role of the department in generating revenue for the medical center, and strategic business concepts. Ability to apply functional area expertise to abstract concepts and make effective real time decisions.
• Knowledge of relevant Managed Care industry federal, state and local laws and regulations. Applies expert policy and organization knowledge to develop improvements to Managed Care policies and processes
• Innovative leadership skills to motivate and influence others. Ability to establish mission and goals at the macro level, reconcile department and organizational goals, align subordinate management to work towards those goals and inspire managers to develop industry leading Managed Care services.
• Proven ability to propose improvements to the Managed Care operations for use of information technology. Ability to assess the impact changes in computer application programs would make on the organization's productivity and quality.
• Expert ability to lead strategic planning and implementation for a multi-faceted health system.
• Highly sophisticated skills in strategy development, systems planning and change management, anticipating issues and responding in an agile way. Expert business development skills to successfully develop and negotiate managed care contractual arrangements.
• Interpersonal skills to maintain professional relationships with organization and industry leaders. Ability to work collaboratively with all levels of employees and managed care partners through soliciting and incorporating their ideas when appropriate, promoting others, and managing conflicts to achieve win-win situations.
• Innovative problem solving abilities to assess intangible variables and think critically to evaluate fundamental issues and identify innovative, industry leading solutions. Expert ability to synthesize and analyze complex data and issues and to crisply articulate the impact.
• Highly-advanced verbal and written communication, facilitation and presentation skills, and a highly persuasive style.

Preferred Qualifications

About UCSF

At UCSF Health, our mission of innovative patient care, advanced technology and pioneering research is redefining what's possible for the patients we serve - a promise we share with the professionals who make up our team.

Consistently ranked among the top 10 hospitals nationwide by U.S. News & World Report - UCSF Health is committed to providing the most rewarding work experience while delivering the best care available anywhere. In an environment that allows for continuous learning and opportunities for professional growth, UCSF Health offers the ideal atmosphere in which to best use your skills and talents.

Pride Values

UCSF is a diverse community made of people with many skills and talents. We seek candidates whose work experience or community service has prepared them to contribute to our commitment to professionalism, respect, integrity, diversity and excellence - also known as our PRIDE values.

In addition to our PRIDE values, UCSF is committed to equity - both in how we deliver care as well as our workforce. We are committed to building a broadly diverse community, nurturing a culture that is welcoming and supportive, and engaging diverse ideas for the provision of culturally competent education, discovery, and patient care. Additional information about UCSF is available at diversity.ucsf.edu

Join us to find a rewarding career contributing to improving healthcare worldwide.

Equal Employment Opportunity

The University of California is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, age, protected veteran status, or other protected status under state or federal law.

Organization

Health

Job Code and Payroll Title

005755 MGD CARE MGR 4

Job Category

Strategy, Supervisory / Management

Bargaining Unit

99 - Policy-Covered (No Bargaining Unit)

Employee Class

Career

Percentage

100%

Location

San Francisco, CA

Campus

Mission Bay (SF)

Work Style

Flexible

Shift

Days

Shift Length

8 Hours

Additional Shift Details

Onsite 3-Days per week