DIRECTOR OF DELEGATION AND VENDOR OVERSIGHT, HEALTH PLAN SERVICES
Cook County Health
Location: Chicago, Illinois
Internal Number: 306596
DIRECTOR OF DELEGATION AND VENDOR OVERSIGHT, HEALTH PLAN SERVICES
:Sep 22, 2022, 9:24:10 PM
:Oct 7, 2022, 4:59:00 AMFull-timeShift Start Time:8:30A.M.Shift End Time:4:30P.M.
Posting Salary:COMPETITIVE SALARY
:Health and Hospital Systems
Director of Delegation and Vendor Oversight, Health Plan Services
Health Plan Services
This position is exempt from Career Service under the CCH Personnel Rules.
The Director of Delegation and Vendor Oversight (DVO), Health Plan Services (HPS) is responsible for directing and leading the management and oversight of delegates and vendors contracted with CountyCare for Medicaid, Medicare, and all future lines of business and oversees HPS' vendor procurement process for all product lines. The Director will oversee management and performance of key partners such as Third-Party Administrator (TPA), Dental, Vision, Transportation, and Pharmacy Benefit Manager. The Director will oversee all HPS vendor contracts and will coordinate procurement processes including, but not limited to, Requests for Proposals (RFP), Development of Scope of Work (SOW), vendor contracting/amendments, and vendor performance evaluation. The Director will oversee the administration of Member Incentive Program/supplemental benefits for all lines of business, managing a team of delegation and vender oversight managers and program management staff.
General Administrative Responsibilities
Review applicable Collective Bargaining Agreements and consult with Labor Relations to generate management proposals
Participate in collective bargaining negotiations, caucus discussions and working meetings
Document, recommend and effectuate discipline at all levels
Work closely with labor relations and/or labor counsel to effectuate and enforce applicable Collective Bargaining Agreements
Initiate, authorize and complete disciplinary action pursuant to CCH system rules, policies, procedures and provision of applicable collective bargaining agreements
Direct and effectuate CCH management policies and practices
Access and proficiently navigate CCH records system to obtain and review information necessary to execute provisions of applicable collective bargaining agreements
Contribute to the management of CCH staff and CCH' systemic development and success
Discuss and develop CCH system policy and procedure
Consistently use independent judgment to identify operational staffing issues and needs and perform the following functions as necessary; hire, transfer, suspend, layoff, recall, promote, discharge, assign, direct or discipline employees pursuant to applicable Collective Bargaining Agreements
Work with Labor Relations to discern past practice when necessary
Directs and leads the departments RFP process, including drafting of the RFP to selection of the vendor
Evaluates current vendor performance and collaborates with all departments to identify if there are gaps or opportunities to utilize new vendors
Chairs the Relationship Review Committee, a committee with senior leadership membership that reviews current vendor performance, vendor contract status, RFPs, and explores potential vendor partnerships.
Directs and develops vendor partnerships through establishing a vendor management process
Establishes a strong working relationship with Supply Chain Management and Procurement
Collaborates with Supply Chain and Finance to ensure execution of procurement processes
Provides recommendations to improve the organization's operations and systems for vendor management
Manages a database of delegates and contracted vendors and ensures that each contract is reviewed on a periodic basis
Implements enhanced capabilities for accountability and integrity of daily operations
Ensures that vendors are aligned with HPS/Cook County Health strategy including customer experience, customer excellence, and operational excellence.
Oversees day-to-day delegation and vendor oversight operations and performance for current and new products
Manages and oversees health plan's delegated vendor auditing program
Ensures that vendor performance issues and day to day issues are tracked, reported and trended. Takes corrective/disciplinary action to address vendor deficiencies
Analyzes vendor performance to identify areas for improvement and implement strategies to effectuate.
Participates in the vendor contract process including the development of service level agreements and key performance indicators.
Develops and implements vendor management policies and procedures both internally and externally (vendor)
Works collaboratively on vendor related initiatives with HPS departments including quality management, customer service and experience, medical management, and claims.
Prepares and presents vendor management reports to stakeholders including executive leadership, directors, managers and committees.
Participates in external regulatory audits and ensures vendor's readiness and participation
Oversees day-to-day operations of HPS' Member Incentive Program and member supplemental benefits to ensure programs are meeting key performance metrics
Ensures successful delivery of HPS' Member Incentive Program and other strategic programs to support HPS membership, retention, and growth efforts.
Analyzes Member Incentive Program data to identify areas for improvement, develop strategies for improvement of programs, and executes implementation of strategies/changes
Prepares and presents Member Incentive Program reports to stakeholders including executive leadership, directors, managers, and committees.
Manages a team of vendor management and program management staff
Performs other duties as assigned
Bachelor's degree from a four-year accredited university Required (Must provide official transcript at the time of interview)
Five (5) years of experience in Medicaid health plan or other government health plan lines of business (i.e., Medicare managed care) including aspects of operations oversight, management, and program management. Required
Three (3) years of experience managing or supervising staff within health plan, large hospital or healthcare environment. Required
Three (3) years of experience managing delegates and vendor relationships such as a Third-Party Administrator, Vision, Dental, Transportation Vendors, Pharmacy Benefit Manager, etc. Required
Two (2) years of experience in developing scopes of work, contract negotiation, or vendor evaluation. Required
Intermediate proficiency using Microsoft Office (Excel, Word and PowerPoint) Required
Masters degree or above from an accredited college or university in health services, business administration, public health, or related discipline (Must provide official transcript at the time of interview)
Experience in project management
Knowledge, Skills, Abilities and Other Characteristics
Knowledge in delegation and vendor oversight in Medicaid and other government products
Knowledge of trends in health care in general, especially underserved populations
Excellent verbal and written communication skills necessary to communicate with all levels of staff and a patient population composed of diverse cultures and age groups
Excellent program development, management and leadership skills
Strong interpersonal skills to build relationships, negotiate and collaborate with individuals, organizations and stakeholders
Demonstrates analytical and organizational, problem-solving, critical thinking and conflict management/resolution skills
Demonstrate attention to detail, accuracy, and precision to support research and presentation skills
Demonstrate good phone and email etiquette skills with strong response times
Demonstrates good computer and typing skills
Demonstrate a strong initiative to innovate, improve health outcomes for individuals and populations and implement integration of behavioral and physical health care
Ability to manage and oversee multiple employees with differing scopes
Ability to conduct activities in accordance with CCH privacy policies and provide leadership to the Plan and organization regarding confidentiality requirements for behavioral health services
Ability to train by presenting concepts and demonstrating tasks
Ability to work flexible hours
Must be able to travel throughout Cook County
Ability to prioritize, plan and organize projects and tasks
Ability to multi-task and meet deadlines in a fast paced and stressful environment
Ability to maintain a professional demeanor and composure when challenged
Ability to function autonomously and as a team member in a multidisciplinary team
Physical and Environmental Demands
This position is functioning within a healthcare environment. The incumbent is responsible for adherence to all hospital and department specific safety requirements. This includes but is not limited to the following policies and procedures: complying with Personal Protective Equipment requirements, hand washing and sanitizing practices, complying with department specific engineering and work practice controls and any other work area safety precautions as specified by hospital wide policy and departmental procedures.
The above statements are intended to describe the general nature and level of work being performed by people assigned to this classification. They are not intended to be construed as an exhaustive list of all responsibilities, duties and skills required of the personnel so classified.
For purposes of the American with Disabilities Act, "Typical Duties" are essential job functions.
When applying for employment with the Cook County Health & Hospitals System, preference is given to honorably discharged Veterans who have served in the Armed Forces of the United States for not less than 6 months of continuous service.
To take advantage of this preference a Veteran must:
Meet the minimum qualifications for the position.
Identify self as a Veteran on the employment application by answering yes to the question by answering yes to the question, "Are you a Military Veteran?"
Attach a copy of their DD 214, DD 215 or NGB 22 (Notice of Separation at time of application filing. Please note: If you have multiple DD214s, 215s, or NGB 22S, Please submit the one with the latest date. Coast Guard must submit a certified copy of the military separation from either the Department of Transportation (Before 9/11) or the Department of Homeland Security (After 9/11).
Discharge papers must list and Honorable Discharge Status. Discharge papers not listing an Honorable Discharge Status are not acceptable
A copy of a valid State ID Card or Driver's License which identifies the holder of the ID as a Veteran, may also be attached to the application at time of filing.
If items are not attached, you will not be eligible for Veteran Preference
VETERANS MUST PROVIDE ORIGINAL APPLICABLE DISCHARGE PAPERS OR APPLICABLE STATE ID CARD OR DRIVER'S LICENSE AT TIME OF INTERVIEW.
Medical, Dental, and Vision Coverage
Basic Term Life Insurance
Deferred Compensation Program
Paid Holidays, Vacation, and Sick Time
You may also qualify for the Public Service Loan Forgiveness Program (PSLF)
Degrees awarded outside of the United States with the exception of those awarded in one of the United States' territories and Canada must be credentialed by an approved U.S. credential evaluation service belonging to the National Association of Credential Evaluation Services (NACES) or the Association of International Credential Evaluators (AICE). Original credentialing documents must be presented at time of interview.
*Please note all offers of Employment are contingent upon the following conditions: satisfactory professional & employment references, healthcare and criminal background checks, appropriate licensure/certifications and the successful completion of a physical and pre-employment drug screen.
*CCHHS is strictly prohibited from conditioning, basing or knowingly prejudicing or affecting any term or aspect of County employment or hiring upon or because of any political reason or factor.
COOK COUNTY GOVERNMENT IS AN EQUAL OPPORTUNITY EMPLOYER
ABOUT COOK COUNTY HEALTH (CCH)
The Cook County Health’s mission is to deliver integrated health services with dignity and respect regardless of a patient’s ability to pay; foster partnerships with other health providers and communities to enhance the health of the public; and advocate for policies that promote the physical, mental and social wellbeing of the people of Cook County.
CCH is comprised of two hospitals, John H. Stroger, Jr. Hospital and Provident Hospital, a robust network of more than a dozen community health centers, the Ruth M. Rothstein CORE Center, the Community Triage Center, the Cook County Department of Public Health, Cermak Health Services, which provides health care to individuals at the Cook County Jail and the Juvenile Temporary Detention Center, and CountyCare, a Medicaid managed care health plan.
The system cares for more than 300,000 patients each year and its physicians are experts in their fields, committed to providing their patients with comprehensive, compassionate and cutting-edge care. Today, CCH is transforming the provision of health care in Cook County by promoting community-based primary and preventive care, growing an innovative, ...collaborative health plan and enhancing the patient experience.
COOK COUNTY HEALTH IS AN EQUAL OPPORTUNITY EMPLOYER