ABOUT THE ROLE
Bright Health Care (BHC) is responsible for the assessment, assembly, management, and commercialization of all of Bright Health’s networks and supporting assets nationally. These “Smart Networks” are payer agnostic, high-performing clinical networks centered around our Care Partners, both owned and affiliated, built to deliver integrated, affordable, and personalized health care through a variety of methods from network contracting to practice acquisition. BHC supports these Smart Networks with the delivery of value-based solutions and services to improve clinical outcomes, enhance patient satisfaction, reduce administrative burden, and lower the total cost of care while moving up the risk continuum to capture additional economic value. The Value Services Organization (VSO) is the commercial vehicle to provide payor agnostic value-based services and solutions to our Smart Network to drive enhanced performance and value-capture from improved care delivery.
Reporting to the SVP of VSO, the VP of VSO Operations will be directly responsible for the development, build, and management of all VSO capabilities, including care management, utilization management, policies and procedures, claims administration, population health data and analytics, value-based network and contracting, and performance reporting, among others. In the short term, this role will provide the operational and tactical leadership to execute on the strategic short and long-term plan for the VSO. In the long-term this role will evolve into oversight and management of the VSO’s clinical and operating performance.
Given the importance of this role to Bright Health Care, you will also work in close collaboration with BHC’s Chief Executive Officer, Chief Medical Officer, Chief Product Officer, and other leaders throughout Bright Health.
- Responsible for design and implementation of a centralized VSO platform to support physician success in value-based and risk-based payment models and oversight of local implementation in strategic markets
- Development of policies and procedures; cross-functional work to ensure regulatory and compliance needs are met at a national and state level
- Evaluation and assessment of business needs, including buy/build/partner assessment for all key functions, including but not limited to: Care Management, Utilization Management, Claims Administration, Population Health Technology and Analytics Platform, Value- and Risk-Based Network Development and Contracting, Coding and Documentation
- Supervises, coaches, and mentors staff and participates in recruiting key roles along with the SVP of VSO
- Establishes performance metrics and goals for the VSO operations team
- Oversees clinical, operational, and financial reporting to managed groups and IPAs
- Drives clinical and operational alignment at the national and local level
- Participates in business development activities as needed
EDUCATION, TRAINING, AND PROFESSIONAL EXPERIENCE
- A Bachelor’s Degree in business, healthcare administration, or a related field is required; MBA/MHA and/or clinical degree is preferred.
- Minimum of 10 years of MSO operations experience, with at least 5 years in a national/regional management role required.
- Experience in change management and process improvement required
- This position will have supervisory responsibility of components of the VSO team.
- Ability to excel in a matrix-ed environment
- Strong clinical leadership skills to ensure trust and respect of clinical staff
- Strong relationship development and management skills within the healthcare provider space
- Results oriented, capable of clearly translating strategic objectives into implementable processes that drive outcomes
- Success in driving organizational change and performance improvement
- Excellent financial and organizational systems acumen
- Strong collaboration skills to ensure effective alignment among diverse teams
At Bright Health, we brought together the brightest minds from the health care industry and consumer technology and together we created Bright Health: a new, brighter approach to healthcare, built for individuals. Our plans are easy to manage, personalized and more affordable, giving people the quality care they deserve. Through our exclusive care partnerships with leading health systems in local communities we are reshaping how people and physicians achieve better health together.
We’re Making Healthcare Right. Together.
We've won some fun awards like: Great Places to Work, Modern Healthcare, Forbes, etc. But more than anything, we're a group of people who are really dedicated to our mission in healthcare. Come join our growing team!
As an Equal Opportunity Employer, we welcome and employ a diverse employee group committed to meeting the needs of Bright Health, our consumers, and the communities we serve. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law.