Morgan Consulting Resources, Inc. is an executive search firm focusing on the Healthcare Industry for over 20 years. We have been retained to conduct the search for a Vice President, Medical Management Operations for Community Health Plan of Washington. This is an outstanding opportunity to join an impressive management team focused on providing their members with the highest quality of care. This position is located in Seattle, WA.
About the organization:
Founded in 1992, Community Health Plan of Washington (CHPW) is a not-for-profit health plan and the only Washington State Medicaid Managed Care Plan governed locally and founded by local community health centers. CHPW provides access to quality Medicaid coverage to Washington’s residents in their own communities. Coverage was expanded to cover Medicare patients in 2009 and CHPW entered the health care marketplace in 2013. Coverage is based upon a model of care that treats the whole person and fosters trust, compassion, respect, and equality.
Programs include: Managed Medicaid (Apple Health); Medicare Advantage (Community HealthFirst), including a Special Needs Plan (SNP); and Washington State Exchange Plans (Community HealthEssentials Plus). CHPW has over 300,000 members served by a health care system of dedicated community and private network providers across the State of Washington.
Community Health Plan of Washington's mission is to deliver accessible managed care services which meet the needs and improve the health of our communities, and make managed care participation beneficial for community-responsive providers.
Excellence in service to our members, providers, and each other is our highest priority.
Every person, every idea counts.
We expect individual accountability for behavior. We share team accountability for performance.
Resource management and productivity are everyone’s responsibility.
Community Health Plan of Washington was founded to provide affordable, comprehensive and quality health care to those who need it most, the underserved, low income populations in communities across the State. The employees of CHPW are passionate about their mission and know their work brings improved health to those most in need. The organization is built on teamwork, dedication to helping others, and with a clear purpose of providing high quality holistic healthcare in partnership with community-based providers. CHPW’s culture is integrally connected to the culture and mission of the community health centers that comprise its governing body.
For more information about Community Health Plan of Washington, please visit: http://www.chpw.org.
About the position:
The Vice President, Medical Management Operations is a new leadership role under the direction of the Chief Medical Officer. The Vice President will be responsible for overseeing utilization, care and disease management teams, as well as community and social services coordination. The organization is in the process of transforming the structure for delivering these services and this leader will be heavily involved in the development, implementation and execution of the organization’s care model and framework for delivering medical management services to its members and support to its provider communities. A visionary leader is needed who can both build and then continue to lead and optimize operations based on key metrics and measurable outcomes. It is expected there will likely be four direct reports and a staff of 100+ that will be developed and trained to meet the UM, CM and DM needs of the Medicaid and Medicare populations. The ideal candidate will be a builder, an innovator, a collaborator, an action taker, a change agent, a strategic thinker, and a strong leader with excellent people skills. Further, the ideal candidate will be attuned to the market developments and innovations in medical management and population health and will be a passionate evangelist for the integrated care model.
Must have proven experience in designing, building and implementing programs, as well as on-going successful operational experience. Expertise in transformational change will be a key to success.
A minimum of ten (10) years of progressively responsible management-level experience in a health plan, preferably Medicaid or Medicare managed care, overseeing medical management programs required.
Familiarity with Medicaid populations required.
Familiarity with Medicare populations and special needs populations highly desired.
Minimum of five (5) years of experience directing medical utilization management, disease management and complex case management functions.
Experience with social determinants of care, behavioral health and community based services as part of an integrated care model.
Bachelor’s degree in Nursing, other clinical licenses such as Nurse Practitioner, Physician Assistant, Medical Doctor or equivalent combination of education and highly relevant experience required.
License Requirement: Registered Nurse (RN), Physician Assistant (PA) or Medical (MD) degree with minimum of 10 years’ experience in practice.
Advanced degree such as MBA, MHA, MPH preferred.
Certificate or degree in analytics or information systems or equivalent experience preferred.
About the location:
Community Health Plan of Washington is conveniently located in vibrant downtown Seattle, WA. Seattle provides breathtaking views of the ocean and mountains with wonderful neighborhoods both in the city and surrounding communities. The list is long of exciting venues, restaurants, events and outdoor recreational activities to enjoy all throughout the Seattle area.
Morgan Consulting Resources is a woman-owned, nationally retained executive search firm with over two decades of experience filling executive roles at healthcare payers and providers and the vendors that support them. Founded by healthcare industry executives, we’re an exclusive firm that only takes on a select number of searches at a time so that we can focus on finding the best possible candidates as quickly as possible for our clients.