Virginia Premier Health Plan has retained Morgan Consulting Resources, Inc. to conduct the search for their Vice President, Health Services. This is an outstanding opportunity to be a highly visible member of a dynamic organization. This position will be based in Richmond, Virginia.
About the company:
Virginia Premier Health Plan is a non-profit managed care organization, locally owned by VCU Health. While they are headquartered in Richmond, they also have a presence in Bristol, Wise, Richlands, Winchester, Roanoke, Tidewater and Northern Virginia. This enables them to serve vulnerable populations throughout the state. Virginia Premier Health Plan focuses their resources on member services, offering a Medicaid Plan, Virginia Premier CompleteCare, a plan for those who are dually eligible, Virginia Premier Elite Plus, a plan for those needing long-term services and supports and Virginia Premier Elite, a Medicare Advantage Plan. They opened their first Patient-Centered Medical Home in Roanoke, VA in 2014. Please visit their website at www.vapremier.com.
Virginia Premier Health Plan’s Commitment and Mission Statements:
Commitment: Helping individuals and families find and fund quality healthcare is at the heart of what we do. We fulfil this objective by delivering easy access to doctors, specialists, hospitals, referrals and emergency aid. In doing so, we act as a strong partner for our members in providing for their health and the health of their families.
Mission: Virginia Premier Health Plan, a managed care organization owned by the Virginia Commonwealth University Medical Center, meets the needs of underserved and vulnerable populations in Virginia by delivering quality driven, culturally sensitive and financially viable healthcare.
About the position:
The Vice President, Health Services will be responsible for oversight and management of integrated health services within the medical management department which encompasses Population Health Management, Utilization Management, Case Management, and Disease Management for all VPHP regions and lines of business. The successful candidate will work collaboratively with the Chief Medical Officer to develop and implement processes to effectively manage clinical policies set by the Medical Management Department to meet healthcare cost and quality targets. This position interprets key performance metrics to develop plans, mobilize the work force, and achieve the organization's medical management outcomes relative to the Quadruple Aim (improved population health, improved experience of care for patients and providers, and lower healthcare costs). The successful candidate will work with the Health Services team to develop and implement effective and efficient standards, protocols, processes, decision support systems, reporting and benchmarks that support ongoing improvements of clinical operations functions and promote quality, cost-effective health care for Virginia Premier Health Plan members. The VP, Health Services will be responsible for effective working relationships with regulatory/community agencies, provider communities, hospitals, and departments within Virginia Premier to improve operations, member outcomes and health plan expansion through growth opportunities. This position serves as part of the executive leadership team and has shared accountability for an integrated approach to meeting overall department and company goals.
Required Education and Experience:
•Registered nurse licensed in Virginia.
•Master’s degree in business or healthcare field.
•Five or more years of experience in managed care medical management and knowledgeable of systems, applicable state, federal and third party regulations.
•Highly motivated individual with the ability to work independently.
•Must possess strong leadership capability, problem-solving, organizational skills, and the desire to foster good working rapport.
•At least 5 years of progressive management experience in the area of health services and medical management and medical expense oversight in an HMO setting.
About Richmond, VA:
Richmond is a city that represents a significant chapter in America’s history, with cobblestone streets, river walks and historical monuments. Originally a colonial settlement, Virginia’s capital is now a thriving hub for culture, shopping and outdoor fun. With lively neighborhoods and a vibrant restaurant scene, Richmond combines big city amenities with southern charm and ease.
If you or someone you know has the qualifications we seek, I'd love to set up a time to talk. Thank you so much for your time.
Morgan Consulting Resources is a women-owned, nationally retained executive search firm with over two decades of experience filling executive roles at healthcare payers and providers and the vendors that support them.