Available Job

Director of Physician Network Operations


Posted February 23, 2021

Physicians Medical Group of San Jose / Excel MSO is looking for the best and brightest professionals to handle the business side of medical practice so “doctors can be doctors.” We are fortunate to have experienced unprecedented growth in the last few years – and we’re just getting started. As the largest Independent Physicians Association in Santa Clara County, not only do we partner with the most health plans, but we’re also the first Clinically Integrated Network in Silicon Valley. We deeply trust and value our dedicated physicians and employees who provide compassionate care to our 100,000 patients every day. If you are looking for a rewarding opportunity with an innovative, collaborative, and inspirational team, join us at PMGSJ / Excel MSO, and help us continue to be trailblazers in the transformation of health care. S UMMARY Excel MSO is currently looking for a Director of Physician Network Operations who will be is responsible for Physician Network Management. The identified candidate would be directly responsible for ensuring that the organization's policies for drafting contracts, conducting negotiations and administering provider agreements are followed. May also be responsible for contractual compliance with government regulations, including local cost of care and trend management provider contracting implementation and local oversight of all types of payment innovation programs and provider relations and education. We are seeking a strategic and forward-thinking individual for this position. ESSENTIAL DUTIES AND RESPONSIBILITIES include the following. Develop and Manage Excel’s key relationships with our most influential strategic provider, Clients and Hospital relationships Create and develop strategies and collaboration focused on strategic relationship management within the organization and your department. Measure business performance; identify/quantify drivers, risks and opportunities for business performance and define solutions to mitigate risks and leverage opportunities Manage a team focused on new and ongoing relationships and service delivery to clients and providers Consult and prepare executive level presentations (both internal and external) Consult with internal partners to design and implement programs to build and nurture positive relationships between the health plan, providers (physician, hospital, ancillary, etc.), and practice managers Establish, cultivate & maintain strong, collaborative working relationships with key internal & external constituencies; including Networks leader, Finance, Communications, Clinical, intersegment partners, key vendors, and senior leadership across the enterprise to advance Excel’s business agenda. Actively seek and engage in community activities, looking for those that align with the client’s interests. Provide feedback to management on market trends as represented by our provider network. Effectively manage escalated issues; helps remove internal/external obstacles to meet client expectations QUALIFICATIONS: Master's degree in healthcare administration, business administration or a closely related field preferred. 7 years minimum work experience in healthcare including at least 5 years at the leadership level. Requires significant strategic experience working within a supplier, hospital setting, hospital system, or association. Experience interacting with a board of directors responsible for directing strategic planning, business planning and/or other organizational development activities. Previous experience working with c-suite level executives. Demonstrated management skills that include making effective and efficient decisions and prudent judgment to achieve long-range and short-term goals. Expert level of proficiency with all facility / ancillary contract reimbursement methodologies 3 years of experience with claims systems Strong knowledge of business processes that impact facility / ancillary contracts Advanced proficiency in MS Office (Excel, Access and PowerPoint) SPECIAL REQUIREMENTS Establish forward-looking goals and deliver results. Supervising and training of department staff. Excellent written and verbal communication and presentation skills and exercise sound judgement. Strong interpersonal, organizational, analytical and critical problem-solving skills. Develop and maintain strong internal and external working partnerships. Leading and Participating in internal and external meetings. Knowledge of Medi-Cal, Medicare and Commercial insurance. Ability to manage multiple tasks in a high-pressure environment. Knowledge of healthcare practice management systems, electronic medical records, and/or billing systems highly desirable. Proficient in the use of Microsoft Office products (Word, Excel, Outlook and PowerPoint). PHYSICAL DEMANDS Constant and close visual work at a desk or computer. Constant sitting and working at a desk. Constant data entry using a keyboard and/or mouse. Frequent verbal and written communication with Providers, Members, internal staff and other business associates by telephone, correspondence, or in person. Frequent walking and standing. Occasional driving of automobile. Due to Covid-19, this position is currently 80% remote. recblid 5g362pm8m109g4ij1lqmreb03casj9

Location/Region: San Jose, CA


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