6 days old

Vice President of Health Services

Des Moines, IA 50309

Job Summary<\/h2>

***Please note that Wellmark is leveraging an Executive Search Partner for this role. Any information you provide may be shared with this firm as part of our assessment process***<\/strong><\/p>


The Vice President of Health Services is responsible for providing leadership and strategic direction to improve the health and care for Wellmark members, ensure health plan quality, and lead development of programs and services to achieve healthcare management goals and objectives. The Vice President is also responsible for oversight of the direction, development, and coordination of all activities and functions of the Quality Improvement, Utilization Management, and Care Management programs intended to intervene and positively impact a members health outcomes and use of the healthcare system.<\/p>

The Vice President of Health Services will work collaboratively with the Chief Medical Officer to develop and implement processes to effectively manage clinical policies set by the Health Services department to meet healthcare cost and quality targets. The Vice President will also work with the health services team to develop and implement effective and efficient standards, protocols, processes, decision support systems, reporting, and benchmarks that support ongoing improvements of clinical operations functions. The successful candidate will meet annual healthcare cost and quality targets for the health plan.<\/p>


The successful candidate will possess a Bachelors degree; a Masters degree in Business or Health Administration is highly preferred. This individual will have 10 years of progressively greater leadership experience and a track record of success leading an operation that impacts the health, well-being, quality, and affordability of care to members and patients in managed care, healthcare services, and/or a company doing innovative work with Health Services. While prior experience overseeing a healthcare services, medical management, and/or clinical services organization is desired, it is not mandatory.<\/p>


The Vice President of Health Services must have a demonstrated leadership capacity to assume oversight and accountability for the operations of a complex business, and the ability to lead and motivate people to achieve agreed-upon results. This individual must have an extensive capacity to think strategically, effective communication skills, and a proven track record of building and maintaining multiple successful partnerships.<\/p>

Specifically, it is important that the candidate has experience or thorough knowledge in the following areas:<\/p>

\u2022 Demonstrated success in developing business strategy, critical decision making, and leading business operations. The ability to translate strategies into plans for execution.<\/p>

\u2022 Experience working in a matrix organization with shared service models.<\/p>

\u2022 Experience working proactively with all stakeholders to identify and meet their needs and requirements. Skilled at establishing and maintaining effective interpersonal relationships with all levels of leaders, physicians, and other providers, employees, and members/customers.<\/p>


\u2022 Proven success in building and mentoring effective leadership teams and demonstrated ability to lead people and get results through others.<\/p>

\u2022 Comprehensive knowledge of managed care operations and how they can work to improve quality of care and affordability. This would include core operations, network management, provider relations, and medical management/care management. An understanding and focus of how the work is reflected in retrospective and prospective product pricing is important.<\/p>

\u2022 Exceptional written and verbal communication skills. Experience in effectively simplifying and presenting complex information to various stakeholders.<\/p>

\u2022 Strong analytical and critical thinking skills. Prior experience of leveraging analytics in business decisions.<\/p>

\u2022 Success in moving from current traditional strategies to new, modified and integrated approaches.<\/p>


\u2022 As a key member of the leadership team, participate in the development and execution of short- and long-term strategic plans required for Wellmarks ongoing growth and success. Collaborate with the team to reach a shared vision regarding health services operations and align the development of the function and respective resources with business growth objectives.<\/p>

\u2022 Develop and foster strong working relationships and communication at all levels of the organization. Foster an environment of collaboration and communication between key functional areas to ensure timely implementation of new strategies and coordinate implementation of corrective strategies to resolve problems or situations that may arise.<\/p>

\u2022 Lead program development strategy to ensure that Wellmarks capabilities to serve members across the continuum of health, chronic disease, and acute care are translated into products and services that provide meaningful benefit to members, purchasers, and the health plan.<\/p>

\u2022 Support network partners in developing effective health and care coordination models and participate in network management processes to assist care systems in designing interventions and support for Wellmarks members in partnership with its health services functions.<\/p>

\u2022 Lead the strategic realignment and clinical transformation of Health Services, resulting in the development and leadership of Wellmark Care Teams which provide oversight of utilization management (UM), care/case management, disease management/condition support, quality and accreditation, outreach, clinical systems applications, and clinical program development for members, creating more efficient and effective processes.<\/p>

\u2022 Perform forecasting and strategic planning for Health Services and Wellmark operations by identifying operational strengths and deficiencies and impacts to the operations of the company.<\/p>

\u2022 Design, develop, and implement programs and service strategies with an emphasis on refining operations, enhancing profitability, and improving member outcomes.<\/p>

\u2022 Provide overall vision, direction, and goals for the team that continues to expand Wellmarks position as a local, regional, and national leader in health and quality outcomes, management of total cost of care, health and wellness solutions, and disease and care management for all conditions.<\/p>

\u2022 Maintain an updated knowledge and application of NCQA, HEDIS, CMS, and other relevant policy and regulatory standards as appropriate to ensure compliance and maintenance of necessary accreditation.<\/p>

\u2022 Ensure optimal member experience through collaboration with the Chief Health Officer in establishing a leadership climate that contributes to a highly engaged workforce committed to Wellmarks members experience.<\/p>

\u2022 Recruit, select, and retain highly qualified professionals. Create a working environment where productivity can be sustained and improved, and where new ideas and personal growth are encouraged and realized. Provide the leadership necessary to maintain a motivated, productive, and competent team through open communication and delegation of responsibilities and authority. Ensure people are in place to drive business results. Guide and direct subordinates in their personal and professional development.<\/p>

\u2022 Participate, as appropriate, in sales and account management meetings.<\/p>

\u2022 Oversee and ensure that the Health Services department has the proper technology and operational systems and controls, administrative and reporting procedures, and talent processes in place.<\/p>

\u2022 Represent Wellmark in external forums to build visibility, develop relationships, and stay abreast of market developments.<\/p>

\u2022 Perform other duties as assigned to meet company objectives.<\/p>


Posted: 2020-05-19 Expires: 2020-06-18

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Vice President of Health Services

Des Moines, IA 50309

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