This position has overall accountability for providing leadership, direction and administration across BUHPs Banner - University Care Advantage (BUCA) BUHPs Medicare Advantage DSNP line of business - and maintaining a high level of visibility at Banner Healths Insurance Division. This position is responsible for driving, supporting and modeling a service-oriented culture focused on employee engagement, quality, service excellence, fiscal responsibility, and the overall member experience. Serves as a member of BUHPs executive leadership, building and supporting effective collegial relationships with applicable internal and external constituents and stakeholders and ensuring optimal operating effectiveness and strategic positioning.
Provides leadership and guidance for the implementation, management and/or oversight of all BUCA functions and departments; articulating and demonstrating an expectation for continuous quality improvement, as well as continually supporting and exhibiting company values and service standards. Directs and ensures the effective identification, recruitment, development, and maintenance of sufficient staffing for current and future organizational needs that are capable of fulfilling all AHCCCS and CMS contract requirements and meeting organizational goals and objectives. Must ensure that BUCA resource allocation is adequate to achieve outcomes and compliance with AHCCCS policy requirements and CMS regulations and sub-regulatory guidance. Sets clear expectations and holds team members accountable for producing desired outcomes. Motivates and develops team members and promotes teamwork.
Provides leadership and is accountable for the achievement of financial and operational performance objectives and expectations including membership growth, revenue growth, operational margin targets, effective expense management and overall efficiency measures. This includes the use of analytical processes to assure the achievement of initiatives and the implementation of performance improvement opportunities in the areas of operational performance, clinical excellence, member satisfaction and employee engagement.
Functions as an integral member of BUHPs operations leadership teams, serving in an advisory capacity to applicable staff. In collaboration with leadership team members, directs and provides oversight regarding the strategic development, implementation, and maintenance of strong, comprehensive BUCA clinical and/or operational services and programs that meet organizational growth initiatives, the needs of member populations, and regulatory compliance standards. Leads and influences change within the insurance division.
Maintains a service excellence and healing culture with high expectations established for positive stakeholder experiences. This culture should create an environment that results in high employee retention and high member and provider satisfaction. This service excellence culture includes ongoing and meaningful communication with employees to ensure that all staff members are well informed and recognized appropriately. Serves as a leader in developing the Continuous Quality Improvement process, in educating staff and role modeling Service Excellence, and in assisting with cultural transformation.
Provides leadership and actively participates in the development and implementation of BUCA strategic, tactical, program and operational planning, including BUCA procurement activities. Utilizes forecasting and planning processes to identify program development opportunities aligned to growth and capability of services offered.
Develops and maintains positive relations with employees, members, families, regulatory agencies, community-based organizations, providers, other contractors, and other BUCA stakeholders, ensuring and fostering a high level of collaboration within a highly matrixed team environment in order to coordinate activities, review work, exchange information, and resolve problems. Promotes collaboration among various stakeholders to achieve optimal results. Maintains on-going communication with employees to ensure that the staff is well informed in regard to the strategic direction of BUHPs Medicare Advantage DSNP line of business.
Collaboratively develops and implements appropriate quality management model(s), member communication, engagement and outreach, internal and external reporting, program evaluation, and other projects as needed. Ensures the timely creation and submission of all required BUCA regulatory deliverables, including the annual Medicare Advantage Bid. Ensures the creation, implementation and compliant maintenance of all required BUCA processes, systems, tracking & trending, policies & procedures, manuals, handbooks, and models necessary to support BUHPs BUCA line of business.
Must possess the knowledge typically gained from the completion of a Bachelor's degree in the business, marketing, or healthcare administration field or the equivalent training and experience.
Requires experience in sales and marketing typically achieved with 7 or more years experience, including supervisory experience . Requires the ability to lead new business development activities, as well as annual business planning/execution and strategic planning as needed. Knowledge of health care and state government, familiarity with Medicaid, Commercial and Medicare related products. Demonstrated leadership capabilities, self-motivation, and a strong understanding of sales and relationship management. Excellent writing, communications and presentations skills are required. Strong analytical skills and ability to establish and maintain effective relationships with customers and gain their trust and respect.
Additional related education and/or experience preferred.
Internal Number: 252803
About Banner Health
You want to change the health care industry – one life at a time. You belong here. You’re excited to be part of the dramatic changes happening in the health care field. In fact, you thrive on change. But you also understand that excellent, compassionate patient care is the true measure of the success of these changes. You belong at Banner Health. Our award-winning, comprehensive health system includes 23 hospitals in seven western states, primary care health centers, research centers, labs, a network of physician practices and much more. Throughout our system, skilled, compassionate professionals use the latest technology to change the way care is provided. If you’re looking to be a key contributor to a forward-looking organization, you’ll experience a wide variety of professional advantages: •Our vision for changing the future of health care gives you the opportunity to leverage your abilities to achieve something historic. •Our expansive system offers you an unmatched variety of clinical settings – from large urban trauma center to small rural hospital, ambulatory to home health. Our system also includes hospitals specializing in cancer, heart health and pediatrics. •Our many loc...ations also translate into a broad selection of exciting and rewarding lifestyle options – from the big city to the wide-open spaces. •Our commitment to healthcare innovation means you always have the latest technologies at your fingertips to help you provide the finest care possible. •The size, success and growth of our system provide you with the stability and options to pursue your desired career path. •Our competitive compensation and comprehensive benefits offer you options to complement your unique needs.