COO Managed Care Population Health

CommonSpirit Health is a nonprofit, Catholic health system dedicated to advancing health for all people. It was created in February 2019 by Catholic Health Initiatives and Dignity Health. With its national office in Chicago and a team of over 150,000 employees and 25,000 physicians and advanced practice clinicians, CommonSpirit operates more than 2,000 care sites from clinics and hospitals to home-based care and virtual care services. Our world needs compassion like never before. Our communities need caring and our families need protection. With our combined resources CommonSpirit is committed to building healthy communities, advocating for those who are poor and vulnerable, and innovating how and where healing can happen -- both inside our hospitals and out in the community.

The purpose of Dignity Health Management Services Organization (Dignity Health MSO) is to build a system-wide integrated physician-centric full-service management service organization structure. We offer a menu of management and business services that will leverage economies of scale across provider types and geographies and will lead the effort in developing Dignity Health?s Medicaid population health care management pathways. Dignity Health MSO is dedicated to providing quality managed care administrative and clinical services to medical groups hospitals health plans and employers with a business objective to excel in coordinating patient care in a manner that supports containing costs while continually improving quality of care and levels of service. Dignity Health MSO accomplishes this by capitalizing on industry-leading technology and integrated administrative systems powered by local human resources that put patient care first.

Dignity Health MSO offers an outstanding Total Rewards package that integrates competitive pay with a state-of-the-art flexible Health & Welfare benefits package. Our cafeteria-style benefit program gives employees the ability to choose the benefits they want from a variety of options including medical dental and vision plans for the employee and their dependents Health Spending Account (HSA) Life Insurance and Long Term Disability. We also offer a 401k retirement plan with a generous employer-match. Other benefits include Paid Time Off and Sick Leave.

This role is responsible for core functional areas for Managed Care Services within the Population Health Services Organization, including claims, contracting, benefits and enrollment, configuration, delegation
oversight, and application development. The position has four primary domains of responsibility: 1) Defining a best-in-class operations organization to support dynamic growth and business expansion, 2) consulting with key business stakeholders to define and communicate future business and operational readiness, 3) driving performance improvement across managed care operations and 4) planning and delivering data and system architecture and providing oversight of business systems operations for assigned departments.

Essential Key Job Responsibilities

1. Provide strategic guidance and oversight for the Managed Care operations functions within the PHSO.
2. Provide oversight of the technical and development operational processes for assigned departments.
3. Build and maintain the technology operations support for the legacy modernization of the infrastructure.
4. Implement processes and protocols for claims, system configuration, and enrollment operations and optimization, including operational processes for applications in preparation for business usage.
5. Manage claims platform operations and application management.
6. Partner with and lead activities of outside consultants and in-house staff to design and implement the technology infrastructure for all areas of oversight, including claims, contracting, benefits and enrollment, delegation oversight, and application development and operations.
7. Define and communicate departmental operational procedures, policies, and standards for acquiring, implementing, and operating new systems, equipment, and software.
8. Hold 24-hour responsibility for the operation of a department or unit and its services, as well as coordinating achievements or responding to challenges across multiple divisions within the organization.
9. Select, develop, and mentor a performance-oriented and responsive team.
10. Build and maintain long-term, sound working relationships across the organization and with partners (clients, staff, vendors, and community).

11. Develop, track, and control the department's annual operating and capital budgets for purchasing, staffing, and operations.
12. Continuously improve department/unit performance, monitoring alignment with budget, operating, and strategic plans.
13. Participate in setting organizational policy and ensure its application across the organization.
14. Understand fiduciary responsibility to the community, operating consistently with the organization's ethics and mission in managing resources to produce high-quality care and satisfaction.

Required Education and Experience:

• Minimum of ten (10) years of experience in Data Governance/ IT Leadership.
• Minimum of five years (5) of leadership experience in a managed care organization, preferably with advanced understanding of claims operations and enrollment, EDI functionality.
• Bachelor's degree in Computer Science, Information Technology, or other related field required.
• Master’s degree in Healthcare or Business Administration preferred.
• Progressive leadership in a large, complex, and integrated healthcare system.
• Strong communication skills, and ability to interface with both administrative and clinical leaders.
• Expertise in process improvement methodology and disciplines; ability to lead/create a culture of process improvement.
• Training and experience in change management, ability to lead organizations through prolonged periods of change.

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