Vice President of Clinical Operations and Performance

Mass General Brigham Health Plan is an exciting place to be within the healthcare industry. As a member of Mass General Brigham, we are on the forefront of transformation with one of the world’s leading integrated healthcare systems. Together, we are providing our members with innovative solutions centered on their health needs to expand access to seamless and affordable care and coverage.Our work centers on creating an exceptional member experience – a commitment that starts with our employees. Working with some of the most accomplished professionals in healthcare today, our employees have opportunities to learn and contribute expertise within a consciously inclusive environment where diversity is celebrated. We are pleased to offer competitive salaries, and a benefits package with flexible work options, career growth opportunities, and much more.Responsibilities:Oversee Clinical operations and performance for MGB Health Plan· Establish and meet department goals and key performance indicators across multiple units· Oversee multiple units within the department including quality, utilization management, case management, disease management, behavioral health, pharmacy, appeals and grievances, and medical policy· Establish targets which support company goals and are aligned with industry benchmarks· Convene and manage forums to monitor current state and discuss interventions· Develop and implement solutions to improve performance· Achieve sales contract performance guarantees related to clinical activities· Achieve compliance requirements related to clinical activities· Report on clinical performance to Board, President and senior leadershipDevelop and implement Clinical strategies for Health Plan· In collaboration with Chief Medical Officer, develop and implement strategies that synergize with Health Plan and Delivery system divisions to improve performance for all lines of business· Monitor industry and local activities to ensure that MGB Health Plan remains competitive in clinical services· Create and implement strategies which achieve industry leading provider and member satisfaction· Assist Health Plan in pursuing new products and entry to new lines of business (e.g. DSNIP)· Inform Health Plan and overall MGB goals

Lead staff and promote positive culture in Clinical department - Oversee ~130 Clinical staff - Improve and standardize hiring processes within Clinical department - Evaluate and sign off on departmental staffing changes - Support staff and implement processes to achieve industry leading performance across all units of clinical department - Implement and standardize best practices such as process maps, root cause analysis, and Lean methodologies - Standardize communication with senior leadership - Model and promote effective change management techniques

Use data and financial analysis to drive strategic and operational decisions· Spread the use of methodologies for evaluating and tracking the success of clinical activities· Promote improved data visualization for key communication and decisions· Increase use of financial models to evaluate potential return of prospective interventions· Inform trend analysis to identify risk and opportunitiesLead high profile strategic initiatives - Oversee strategic initiatives as they arise such as utilization management efficiency investments - Execute reorganization of clinical department ensuring gains in performance and efficiency - Support other senior leaders with dependencies on clinical department

Manage budget for Clinical department - Manage finances of department to ensure expenses are within $11M clinical budget - Develop future clinical budgets in collaboration with other senior leaders - Hold clinical leaders accountable for unit budgets

Foster collaborative relationships with customers and stakeholders· Provide leadership and oversight in a way that promotes a supportive, respectful environment· Develop effective relationships with leaders and staff in the Health Plan and with Population Health Management· Present ideas, updates, findings, reports, recommendations, data, and analysis to various audiences to build consensus on clinical initiatives

Use Mass General Brigham healthcare values to govern decisions, actions, and behaviors· These values govern how we get our work done: Patients, Affordability, Accountability & Service Commitment, Decisiveness, Innovation & Thoughtful Risk; and how we treat each other: Diversity & Inclusion, Integrity & Respect, Learning, Continuous Improvement & Personal Growth, Teamwork & CollaborationQualifications:· Bachelors degree required· Advanced degree strongly preferred· 15+ years’ experience in health care· 10+ years’ experience in leadership· Experience presenting to boards and senior leaders· Experience leading high profile, complex clinical initiatives· Experience managing budgets in excess of $10M· Experience with process improvement techniques and change management· Experience in both Health Plan and delivery system preferredEEO StatementMass General Brigham is an Equal Opportunity Employer. By embracing diverse skills, perspectives and ideas, we choose to lead. All qualified applicants will receive consideration for employment without regard to race, color, religious creed, national origin, sex, age, gender identity, disability, sexual orientation, military service, genetic information, and/or other status protected under law. We will ensure that all individuals with a disability are provided a reasonable accommodation to participate in the job application or interview process, to perform essential job functions, and to receive other benefits and privileges of employment.