Regional Vice President (Clark County, NV)

Alignment Health is breaking the mold in conventional health care, committed to serving seniors and those who need it most: the chronically ill and frail. It takes an entire team of passionate and caring people, united in our mission to put the senior first. We have built a team of talented and experienced people who are passionate about transforming the lives of the seniors we serve. In this fast-growing company, you will find ample room for growth and innovation alongside the Alignment Health community. Working at Alignment Health provides an opportunity to do work that really matters, not only changing lives but saving them. Together.

The Regional Vice President (RVP) to be responsible for the operations and profitability of a particular market. Working closely with the Regional Medical Officer, they will lead the market’s provider network relationships.

GENERAL DUTIES/RESPONSIBILITIES (MAY INCLUDE BUT ARE NOT LIMITED TO):
1.    Develops strong relationships with key stakeholders, physician leaders, network physicians, hospitals, and ancillary providers.
2.    Works closely with Regional Medical Officer and collaborates with other departments to ensure overall success of the market. Meets and exceeds budget and operating goals.
3.    Develops and implements initiatives to increase patient satisfaction, coding accuracy, STARS, and other quality programs.
4.    Assists in the top-line activities of the market and ensures all market goals are met.
5.    Analyzes, negotiates, and drafts contract rate and language proposals.
6.    Conducts regular meetings with specified providers to review and improve operational and financial results. Clearly communicates Company’s mission and values and operational and clinical imperatives.
7.    Identifies and contracts with new PCPs and specialists to develop the network.
8.    In conformance with corporate standards, negotiates, implements, and manages capitated and fee-for-service agreements with individually contracted Primary Care Physicians (PCP), medical groups, hospitals, ancillary providers, and specialists. Administer those contracts to ensure anticipated results.
9.    Collaborates with other market RVPs to promote adoption of best practices
10.    Contributes expertise to development of organizational best practices.

Supervisory Requirements:

Oversees assigned staff. Responsibilities include recruiting, selecting, orienting, and training employees; assigning workload; planning, monitoring, and appraising job results; and coaching, counseling, and disciplining employees.

Job Requirements:

Experience:

• Required: Minimum 10 years' experience in managed care or health care field, including a strong understanding of reimbursement methodologies, contract language, negotiation strategies, financial modeling and analysis, managed care and Medicare Advantage plans. Minimum 5 years of experience with delegated and non-delegated providers

• Preferred: Supervisory experience.

Education:

• Required: Bachelor's degree.

• Preferred: MBA

Training:

• Required:

• Preferred:

Specialized Skills:

• Required:

• Excellent knowledge of hospitals and managed care finance and contracts
• Proven ability to foster collaboration, value others perspective and gain support and buy-in for organization proposal.
• Ability to communicate positively, professionally and effectively with others; provide leadership, teach and collaborate with others.
• Excellent Microsoft Office skills, including Word and Excel
• Effective written and oral communication skills; ability to establish and maintain a constructive relationship with diverse members, management, employees and vendors;
• Mathematical Skills:  Ability to perform mathematical calculations and calculate simple statistics correctly
• Reasoning Skills:  Ability to prioritize multiple tasks; advanced problem-solving; ability to use advanced reasoning to define problems, collect data, establish facts, draw valid conclusions, and design, implement and manage appropriate resolution.
• Problem-Solving Skills:  Effective problem solving, organizational and time management skills and ability to work in a fast-paced environment.
• Report Analysis Skills:  Comprehend and analyze statistical reports.

Licensure:

• Required: None

Other:

• Able to travel by car or air
• Available for evenings / weekends and extended work hours as needed

Work Environment:

The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job.  Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

Essential Physical Functions:

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. 

Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

1 While performing the duties of this job, the employee is regularly required to talk or hear. The employee regularly is required to stand, walk, sit, use hand to finger, handle or feel objects, tools, or controls; and reach with hands and arms.

2 The employee frequently lifts and/or moves up to 10 pounds. Specific vision abilities required by this job include close vision and the ability to adjust focus.

Pay Range: $0.00 - $0.00

Alignment Health is an Equal Opportunity/Affirmative Action Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability, age, protected veteran status, gender identity, or sexual orientation.

*DISCLAIMER: Please beware of recruitment phishing scams affecting Alignment Health and other employers where individuals receive fraudulent employment-related offers in exchange for money or other sensitive personal information. Please be advised that Alignment Health and its subsidiaries will never ask you for a credit card, send you a check, or ask you for any type of payment as part of consideration for employment with our company. If you feel that you have been the victim of a scam such as this, please report the incident to the Federal Trade Commission at https://reportfraud.ftc.gov/#/. If you would like to verify the legitimacy of an email sent by or on behalf of Alignment Health’s talent acquisition team, please email careers@ahcusa.com.