Director, Clinically Integrated Network Operations
About The Position
The Director of CIN Operations is responsible for overseeing the strategic, operational, and financial performance of the organization's Clinically Integrated Network(s) (CIN) and other affiliated network organizations. This role ensures effective care coordination, population health management, regulatory compliance, and achievement of quality and cost targets under value-based care payment and care models. Must have strong background in contracting, and managing, complex value-based reimbursement models across multiple lines of business (LOB) (e.g. Medicare, Medicaid, Medicare Advantage, Commercial, etc.) and through multi-party (hospitals, physicians, allied health providers, etc) entities.
Requirements
- Bachelors Degree in Healthcare Administration, Business, Nursing, or related field required
- 7 or more years of healthcare experience
- Strong knowledge of value-based care models and healthcare reimbursement
- Experience with healthcare analytics and performance metrics
- Excellent leadership, communication, and stakeholder management skills
- Financial acumen and strategic planning expertise
- Familiarity with EHR systems and population health platforms
Nice To Haves
- Master's Degree MHA, MBA, MPH, or similar
- 3 or more years in CIN, population health, or value-based care leadership
- Experience with CMS ACO programs (e.g., MSSP)
Responsibilities
- Develop and execute CIN operational strategies aligned with organizational goals
- Partner with executive leadership to drive value-based care initiatives
- Coordinate all board and governance related activities of the CIN
- Lead growth and optimization of CIN programs and payer contracts
- Oversee daily CIN operations, including care coordination, network performance, and provider engagement
- Implement workflows to improve efficiency and patient outcomes
- Monitor and improve operational KPIs
- Direct population health strategies, including risk stratification and care management programs
- Ensure effective transitions of care and chronic disease management initiatives
- Collaborate with clinical leaders to improve quality outcomes
- Manage CIN budgets, shared savings/loss models, and cost containment strategies
- Analyze utilization, cost trends, and financial performance
- Identify opportunities for savings while maintaining quality care
- Ensure compliance with CMS and other regulatory requirements
- Monitor quality metrics (e.g., HEDIS, CMS ACO measures)
- Lead quality improvement initiatives and reporting
- Utilize data analytics to drive decision-making and performance improvement
- Oversee reporting dashboards and performance tracking
- Translate data insights into actionable operational strategies
- Build strong relationships with physicians, hospitals, and network providers
- Support provider education on value-based care and CIN performance
- Collaborate with payers and external partners
- Must be able to perform the professional, clinical and or technical competencies of the assigned unit or department.
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What This Job Offers
Job Type
Full-time
Career Level
Director
