Why join Scripps Health?

AWARD-WINNING WORKPLACE:

* #5 in Fortune Best Workplaces in Health Care 2023

* #78 in 2023 PEOPLE Companies that Care

* #95 in Fortune 100 Best Companies to Work for 2023

* Recognized by Newsweek as one of America's Greatest Workplaces for Diversity in 2024

* Nearly a quarter of our employees have been with Scripps Health for over 10 years.

The Vice President, Payer Relations has enterprise level responsibility for providing strategic and operational leadership in the development and execution of all types of payer contracting programs and provider partnership strategies for all lines of business (including commercial, senior, fee for service and value based).

This role serves as the face of the system to all payers and their partners. Will lead a cross functional teams that have substantial impact on quality, revenue and growth across all Scripps Health business units. The Vice President is expected to exercise independent judgment in the day-to-day management of the organization's contracting and managed care activities.

O You will proactively support the Mission, Vision, Philosophy and Values of the Scripps Health organization and is sensitive and responsive to the unique cultures and deeds of the assigned business unit.

O Ensure achievement of net revenue targets through contract negotiations with Commercial HMO/PPO payers, California Medi-Cal, Medicare Advantage Plans, County Medical Services, TriCare, and other purchasers.

O Support business unit-specific and medical group-specific payer contract needs, such as Center of Excellence contracting for tertiary programs, physician relations for program development, and major "wholesale" payer relationships.

O Apply financial and analytic acumen to work in order to achieve outcomes.

O Supports physician network development and joint venture development through planning and payer contract support.

O Maintain close working relationship with affiliated physicians and groups, including joint contracting, planning, and joint ventures.

O Work with management to ensure that the staff is appropriately trained in order to maintain the highest level of effectiveness and efficiency.

O As appropriate, play an advocacy role in the community as it relates to such issues as managed care regulations and government program reimbursement.

O Ensure regional compliance with local, state and federal regulations and standards.

O Is a member of executive leadership and promotes system wide strategies.

O Perform other duties as assigned by the Executive Vice President, Chief Growth Officer.

O In conjunction with peer executives, service line directors and finance prepare operating and capital budgets to ensure that the appropriate resources are allocated and invested to meet the health service delivery needs for assigned business unit.

O Lead, consistent with Scripps management system, the development of key performance indicators, reporting of such and the development of management systems to ensure achievement of such KPIs for business units.

O Responsible for ensuring that established financial and quality goals are achieved.

O Participate in the formulation and/or update of the business unit operations and annual strategic plan.

O Direct the formulation and/or update of the annual strategic plans for assigned business unit to fulfill the goals and objectives of the systems strategic plan.

O Meet regularly with clinical staff leadership, the medical consultant, and independent physicians to ensure the integrity of professional and technical aspects of programs and services offered to achieve optimal clinical outcomes, patient satisfaction and efficiencies in resource consumption.

O Maintain productive working relationships.

O Provide the leadership necessary to ensure the business unit is responsive to the continuing healthcare needs of the communities it serves.

O Ensure that the care of patients is of the highest professional quality and meets the standards prescribed by licensing and accrediting bodies of Scripps Health.

O Provide leadership in corporate-sponsored project teams to achieve continuity in the system wide care continuum and supports performance improvement efforts at the business unit.

This Vice President position is located at Scripps Health Administrative corporate office in La Jolla.

Required Education/Experience/Specialized Skills:

• Master's Degree in a related field or an equivalent combination of education and experience.
• A seasoned executive with five or more years of operations experience who has demonstrated increasingly responsible experience in healthcare administration.
• Must demonstrate a track record of being an accomplished executive with health care system experience.
• Extensive strategic planning and budget formulation skills at an executive level with complex analytical and problem-solving skills.
• Must possess strong leadership skills and be an effective team builder.
• Must possess a system mindset and be supportive of Scripps Health, understanding the value of being part of a strong system.
• Dedication to excellence and innovation regarding continuous quality improvement, patient care models and clinical integration.
• Knowledge and understanding of the driving forces in the local, state, and national healthcare markets and the ability to assess emerging trends and needs and develop plans to address such trends.
• A demonstrated record of and concern for positive employee relations.
• Must be community oriented and committed to the concept of a healthy community.
• Must possess excellent written, verbal and listening communication skills and be comfortable and effective in working with all levels of management, Board, employees, physicians, the community and donors.
• Must evidence a commitment to continuing professional development.
• Knowledge of State and Federal Healthcare regulations including relating to payer contracts, payment guidelines, etc.

Preferred Experience:

• Executive experience developing and executing So. California market strategy, network development, and contracting for Medical Groups, IPAs and Hospitals throughout Southern California for all lines of business (Commercial, Medicare, and Medicaid).
• Previous experience in business development, product development and implementation, affordability initiatives, value-based contracting, legislative and regulatory compliance, delegation oversight and resolution, and maintaining and building provider relationships.