AVP, Operations & Value Stream Integration, Full Time, Days

Jackson Health•Miami, FL

6d•Onsite

About The Position

The Associate Vice President (AVP) of Operations and Value Stream Integration provides executive leadership for the operational execution of Jackson Health System's population health and value-based care strategy. The incumbent owns the build, governance, and performance of the Jackson Value Based Enterprise (VBE) and Clinically Integrated Network (CIN), and directs the enterprise Population Health Department's care management programs across the continuum. The role integrates clinical, operational, financial, and contractual value streams so that care delivery, network performance, and payer arrangements advance the organization toward value-based and risk-based models. Working with physicians, payers, internal leaders, and community partners, the incumbent converts strategy into measurable gains in quality, utilization, total cost of care, and patient engagement.

Requirements

Generally requires 7 to 10 years of related experience.
Management experience is required.
Master's degree in Business Administration, Healthcare Management, or a related field is required.
Valid license or certification is required as needed, based on the job or specialty.

Responsibilities

Lead the phased development, operation, and growth of the Jackson Health System Value Based Enterprise (VBE) and Clinically Integrated Network (CIN), building network structure, participation criteria, and governance, and supporting VBE and CIN boards and committees.
Recruit and onboard employed, affiliated, and community physicians into the network in partnership with Physician Services and Credentialing.
Establish and enforce network-wide clinical quality standards, care protocols, and physician performance metrics, including scorecards and performance reviews tied to quality, utilization, and cost targets.
Oversee development of clinical integration infrastructure, including shared care protocols, data sharing, attribution, and compliance with applicable regulations such as Stark, Anti-Kickback, and VBE safe harbor requirements.
Develop and manage the VBE and CIN operating budget and, as value-based arrangements are established, the methodology for distributing shared savings and incentive payments.
Direct the operations of the enterprise Population Health Department and its care management model.
Use data and risk stratification to identify and engage high-risk and rising-risk patients, including unfunded and underinsured populations.
Oversee care navigation, transitions of care, chronic care management, preventive care, disease education, and social determinants of health screening and intervention.
Expand primary care, specialty, and community-based resources available to engaged patients, shifting utilization from emergency and inpatient settings to coordinated ambulatory care.
Track engagement, utilization, readmission, and cost savings outcomes, and pursue grant, philanthropic, and partnership funding to sustain and scale programs.
Collaborate with management services organization (MSO) partners and Managed Care leadership to co-develop value-based arrangements and manage their performance.
Translate arrangement terms into operational workflows, quality measure targets, and care management priorities across the network.
Monitor arrangement performance, recommend improvements to financial and clinical results, and support due diligence on new value-based opportunities. This responsibility applies to new value-based arrangements and does not change the administration of existing managed care agreements.
Lead the formulation and execution of operational plans that align population health and value-based care objectives with enterprise strategy while ensuring regulatory compliance and adherence to industry best practices.
Oversee translation of organizational objectives into operating models that inform annual budgeting, staffing, and resource allocation processes.
Integrate clinical and business processes across hospitals, ambulatory and primary care, physician groups, and community partners to ensure seamless coordination of care.
Align internal workflows with external value-based relationships, including care pathways between inpatient and outpatient settings.
Drive data integration and interoperability, including population health tools and registries in the electronic health record, so care teams and network physicians have timely, actionable patient information.
Establish, monitor, and report metrics and benchmarks for quality, utilization, total cost of care, patient engagement, and network performance.
Spearhead performance improvement methodologies, such as Lean and Six Sigma, to identify operational gaps and standardize processes across the care continuum.
Report results regularly to executive leadership, VBE and CIN governance, and other stakeholders.
Provide visionary leadership to directors, managers, navigators, and care management teams by setting strategic goals, mentoring leaders, and fostering a culture of accountability and high performance.
Champion an inclusive, collaborative environment and lead change management for the transition to value-based care.
Empower teams through tailored training and development initiatives that build operational and clinical integration capabilities.
Build and manage relationships with payers, physicians, management services organizations, community organizations, academic partners, and funders.
Represent the organization in strategic forums, industry events, and stakeholder meetings on value-based care, clinical integration, and population health.
Monitor emerging payment models and best practices to continuously refine strategic approaches.
Perform other related executive functions and duties as assigned to support Jackson Health System's mission and strategic objectives.