VP Medical Management-Managed Care

CommonSpirit Health • Bakersfield, CA

19d • Remote

About The Position

This role is the key clinical leader for Managed Care Services within the Population Health Services Organization, responsible for providing the clinical vision, strategy, and agenda. Reporting directly to the System VP, Population Health Physician Executive, this role will drive clinical excellence, accountability, and alignment across the contracted physician networks, impacting key performance indicators related to utilization and cost, quality, and both member and provider experience. This role requires a physician leader with a strong understanding of managed care operations, who can collaborate effectively with diverse stakeholders to deliver uniform and cohesive clinical services across the managed care populations. This leader will have direct oversight of the Medical Director of Utilization Management (UM) and the Medical Director of Physician Engagement and Quality, as well as providing clinical leadership and guidance to other physician medical directors within the UM department, ensuring the realization of the clinical vision and strategic objectives. Please note this is a REMOTE role. The position has three primary domains of responsibility: 1) Establish clinical strategy to be scaled across the Managed Care organization. 2) Drive advancement of clinical excellence, clinical performance / accountability, and clinical alignment across physicians in the networks. 3) Partner with Managed Care operations teams to bring uniform and cohesive clinical services across all provider and patient populations. Job Requirements We are seeking a strategic and dynamic Physician Executive to drive the evolution and success of our Managed Care services and provider partnerships. This role is crucial for optimizing clinical and operational strategies, fostering growth, and transforming healthcare delivery.

Requirements

• Minimum of eight (8) years of clinical experience in specialty.
• Minimum of five years (5) of direct management / people manager experience in health care.
• Medical degree or DO degree.
• MD/DO - Current license to practice medicine within the State of California and prior (or current) Board Certification in a specialty are required.
• Progressive leadership in a large, complex, and integrated healthcare system
• Understanding of Healthcare Industry's trending direction and regulatory considerations; ability to identify and implement market level opportunities.
• Healthcare operational and financial acumen and knowledge and experience leading complex and innovative delivery models.
• Experience in Utilization Management activities.
• Strong communication skills, and ability to interface with both administrative and clinical leaders.
• Expertise in process improvement methodology and disciplines; ability to lead/create a culture of process improvement.
• Training and experience in change management, ability to lead organizations through prolonged periods of change.

Responsibilities

• Strategic Leadership Develop and execute progressive clinical and operational strategies to optimize services, drive organizational growth, and innovate Managed Care models.
• Provider Engagement & Relations Lead the development of strong, collaborative relationships with independent community physicians, hospital-based providers, and other groups. Align providers with common clinical visions, strategic incentives, and quality improvement initiatives, focusing on population health management.
• Operational & Clinical Oversight Provide strategic guidance for Managed Care Provider Relations, Customer Service, and Clinical Oversight functions. Oversee and manage the medical director capacity to support Managed Care Services and approve all contracted relationships. Ensure a culture of open communication and collaboration among medical directors and all partnering clinicians.
• Team Leadership & Development Mentor and lead administrative and clinical teams to scale provider relations, ensuring performance and compliance standards are met.
• Strategic Partnerships Collaborate closely with the Managed Care COO to ensure contract compliance and successful management of the managed care population. Build effective relationships with partners, payers, businesses, and the community.
• Policy & Performance Participate in setting organizational policy, maintain a visible presence with key stakeholders, and continuously improve departmental performance in alignment with budget and strategic plans.

Benefits

• Dignity Health MSO offers an outstanding Total Rewards package that integrates competitive pay with a state-of-the-art, flexible Health & Welfare benefits package.
• Our cafeteria-style benefit program gives employees the ability to choose the benefits they want from a variety of options, including medical, dental and vision plans, for the employee and their dependents, Health Spending Account (HSA), Life Insurance and Long Term Disability.
• We also offer a 401k retirement plan with a generous employer-match.
• Other benefits include Paid Time Off and Sick Leave.

What This Job Offers

• Job Type: Full-time
• Career Level: Executive
• Education Level: Ph.D. or professional degree
• Number of Employees: 5,001-10,000 employees