Director of Payor Performance and Network Operations

We’re a physician-led, patient-centric network committed to simplifying health care and bringing a more connected kind of care.

Our primary, multispecialty, and urgent care providers serve millions of patients in traditional practices, patients' homes and virtually through VillageMD and our operating companies Village Medical, Village Medical at Home, Summit Health, CityMD, and Starling Physicians.

When you join our team, you become part of a compassionate community of people who work hard every day to make health care better for all. We are innovating value-based care and leveraging integrated applications, population insights and staffing expertise to ensure all patients have access to high-quality, connected care services that provide better outcomes at a reduced total cost of care.

Please Note: We will only contact candidates regarding your applications from one of the following domains: @summithealth.com, @citymd.net, @villagemd.com, @villagemedical.com, @westmedgroup.com, @starlingphysicians.com, or @bmctotalcare.com.

At VillageMD, we're looking for a Director of Payor Performance and Network Operations to help us transform the way primary care is delivered and how patients are served. As a national leader on the forefront of healthcare, we've partnered with many of today's best primary care physicians. We're equipping them with the latest digital tools. Empowering them with proven strategies and support. Inspiring them with better practices and consistent results.

We're creating care that's more accessible. Effective. Efficient. With solutions that are value-based, physician-driven and patient-centered. To accomplish this, we're looking for individuals who share our sense of excellence, are ready to embrace change, and never settle for the status quo. Individuals who have the confidence to lead but the humility to never stop learning.

In this role, you will work will all markets to improve and enhance the performance of all payor contracts under value-based contracts across the enterprise. You will collaborate with VillageMD teams and network practice staff to integrate analytic, ancillary and operations capabilities to manage patient populations against improvements in the ‘Quadruple Aim’ of healthcare: better outcomes, lower cost and an improved patient and clinician experience.

Could this be you?

As a Payor Performance and Network Operations Director you are responsible for the strategic development, implementation, and oversight of the organization's specialty network workflows and outcomes. You will design, monitor, and continually improve market processes, , nurture and grow payor relationships and reduce healthcare costs. Resource for network contracting to resolve issues or provide negotiation strategy for specialty network relationships. Monitor, report, and optimize clinic, market and payor operational and financial performance. All in all, this role requires a deep understanding of payor and primary care-specialist relationships, healthcare analytics, and the ability to collaborate and liaise effectively with various stakeholders, including physicians, administrative staff, senior leadership, payers, and community partners.

How you can make a difference

• Strategic Planning & Program Development: Develop and implement the organization's specialty network and referral strategy, including identifying areas for improvement, selecting appropriate referral models, establishing performance metrics, and monitoring and providing feedback and support on market and payor performance.
• Data Analysis & Performance Improvement: Utilize data analytics to monitor performance, identify areas for improvement, and develop strategies to optimize payor program outcomes. This includes analyzing cost, quality, and utilization data.
• Physician and Clinical Staff Engagement & Alignment: Engage and align physicians and other clinical and operational staff in targeted initiatives, providing education, resources, and support to ensure successful implementation.
• Collaboration: Work collaboratively with market leadership to develop and execute on all available contract levers to achieve optimal performance.
• Quality Improvement & Patient Experience: Lead initiatives to improve the quality of care and enhance the patient experience within the context of specialty network and referral processes.
• Regulatory Compliance: Ensure compliance with all relevant regulations and reporting requirements related to all applicable initiatives.
• Team Leadership & Development: Guide and develop other managers through strategic alignment, setting clear and concise goals, and building trusting relationships that will allow you to influence decisions and get buy-in from your team members.
  Market Analysis & Research: Stay abreast of industry trends, best practices, and emerging care and operational models, conducting market analysis to identify new opportunities.
• Effective Communication: Lead weekly and monthly operating performance reviews driven from core, standard operational reporting.

Core competencies

• Emotional Intelligence
• Influence
• Excellent communication, interpersonal, and presentation capabilities
• Ability to analyze complex data and develop actionable insights
• Cultivate clinical and business partnerships
• Strong problem-solving and decision-making abilities

Skills for success

• A consistent track record of leadership including the ability to achieve results with and through others
• A talent for balancing critical thinking with hands-on execution
• A desire to be accountable for owning problems, with a strong results-orientation
• Finesse in partnering with physicians on change management initiatives
• The knowledge to validate data directly tied to population health and value-based care

Experience to drive change

• Bachelor’s degree in healthcare administration, business administration, or a relevant field required; master’s degree preferred
• Minimum of 7 years of management experience in the healthcare industry
• Considerable experience with Population Management and Value-Based Care operations, ideally in a leadership role working with physician practices
• Validated ability to implement data into practice; respond to analytical insights with strategies and solutions that impact the provision of care; evidence-based decision-making skills
• Direct experience working with physicians including the ability to use data to influence physician behavior
• Prior experience handling a P&L or accountability for a large-scale project, initiative, or department
• Proficiency with Microsoft Excel and PowerPoint required
• Experience with Electronic Medical Records (EMR) and work with healthcare data and reporting is strongly preferred

This is an exempt position. The base compensation range for this role is $120,800 to $151,100.  At VillageMD, compensation is based on several factors including, but not limited to education, work experience, certifications, location, etc.  The selected candidate will be eligible for a valuable company benefits plan, including health insurance, dental insurance, life insurance, and access to a 401k plan.

Our team members are essential to our mission to reshape healthcare through the power of connection. VillageMD highly values the critical role that health and wellness play in the lives of our team members and their families.  Participation in VillageMD’s benefit platform includes Medical, Dental, Life, Disability, Vision, FSA coverages and a 401k savings plan.

Our Company provides equal employment opportunities (EEO) to all employees and applicants for employment without regard to, and does not discriminate on the basis of, race, color, religion, creed, gender/sex, sexual orientation, gender identity and expression (including transgender status), national origin, ancestry, citizenship status, age, disability, genetic information, marital status, pregnancy, military status, veteran status, or any other characteristic protected by applicable federal, state, and local laws.

Our Company cares about the safety of our employees and applicants. Our Company does not use chat rooms for job searches or communications. Our Company will never request personal information via informal chat platforms or unsecure email. Our Company will never ask for money or an exchange of money, banking or other personal information prior to the in-person interview. Be aware of potential scams while job seeking. Interviews are conducted at select Our Company locations during regular business hours only. For information on job scams, visit, https://www.consumer.ftc.gov/JobScams or file a complaint at https://www.ftccomplaintassistant.gov/.