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Job Title

Vice President, Columbia Pacific CCO

Exemption Status

Exempt

Management Level

Vice President

Direct Reports

CCO Leaders and Staff

Manager Title

Chief Medicaid Programs Officer

Department

Columbia Pacific CCO

Requisition

25049

Pay & Benefits

Estimated hiring range $219,780 - $268,620 / year, 10% bonus target, full benefits. www.careoregon.org/about-us/careers/benefits

Posting Notes

This is a hybrid position with 2 days/week in the community, candidates will need to be local to the Portland Metro area or our CPCCO region (Tillamook, Clatsop and Columbia counties)

Job Summary

Columbia Pacific CCO is a Coordinated Care Organization (CPCCO), providing services under the Oregon Health Plan, Healthier Oregon Program and/or Basic Health Plan in Columbia, Clatsop and Tillamook Counties. Columbia Pacific CCO was created in 2012 and is the sole CCO in its service region. With a mission “to inspire local connections that foster member health and community resilience,” CPCCO believes that building community and fostering collective action is the means to achieving not only health transformation but also more stable, sustainable and impactful programs to help individuals achieve their best lives. As a not-for-profit health plan, it is dedicated to investing in high-priority health improvement focus areas identified by local communities and by CareOregon and CCO-facing staff.

This position executes Columbia Pacific CCO’s vision, strategic initiatives, business plan, and public policy agenda. This position has overall accountability for the OHA CCO contract and is responsible for developing and communicating the organization’s direction and implementing effective strategies to ensure a highly functioning CCO. As such, this position carries accountability for assuring the operational performance and financial stability and profitability of the CCO. The Executive reports to both the CCO Board of Directors and CareOregon’s Chief Medicaid Programs Officer. The individual is responsible for managing the CCO board and its governing committees. The Executive works closely with CareOregon leadership to ensure the long-term success of the CCO and CareOregon. The position also serves on the CareOregon Strategic Executive Team to bring the line of business perspective to corporate leadership discussions. This position also acts as primary CCO liaison to OHA leadership, including the Medicaid Director, the OHA Deputy Director and other OHA equity and transformation staff.

Essential Responsibilities

Vision

+ Develops organizational policies and position accountabilities that advance Columbia Pacific CCO’s mission and vision.

+ Ensures Columbia Pacific CCO’s business initiatives are aligned with the five-year Regional Health Improvement Plan, the annual CCO Strategic Plan, CareOregon’s Strategic Plan, CareOregon’s annual success indicators, the annual OHA contract and the revenue forecasts for the CCO.

Governance

+ Guides and collaborates with the Columbia Pacific CCO Board to develop high-functioning committees and other governance structures, policies and decision frameworks.

+ Collaborates with the CCO Board regarding development and performance of the CCO Executive.

+ Recruits and develops new board members to assure diverse perspectives on the governing board and CCO committees.

+ Develops strategic initiatives and policy updates for Board input and approval, as appropriate.

+ Develops agendas and topics for Board meetings, assuring achievement of Board-identified strategic priorities and emerging state/regulatory requirements.

+ Develops, manages and reports grants and other CCO programs to assure Board oversight of and agreement with strategic investments in community- and staff-identified member and community health priorities.

+ Engage the Community Advisory Council in strategic direction of the organization.

Public Policy and External Environment

+ Provides overall direction to the CPCCO Leadership Team to develop and implement Columbia Pacific CCO’s priority initiatives with clinical and non-clinical community partners, CareOregon, the State and other regional stakeholders.

+ Advocates for Columbia Pacific CCO’s agenda in alignment with the CareOregon CCO model and as an agent of change to transform the health of its members and communities.

+ Establishes Columbia Pacific CCO’s contracts and success indicators with delivery system, community and policymaking partners to shape CCO outcomes consistent with OHA and other regulatory requirements.

+ Represents CPCCO with Oregon Health Authority, Oregon Health Policy Board and in other state policy venues.

+ Enhances stakeholder partnerships to expand Columbia Pacific CCO’s advocacy on legislative policy issues and the future direction of Oregon’s Medicaid programs.

Operations

+ Provides oversight of CareOregon staff operating according to the Delegation Agreement and Management Services Agreement between CareOregon and the CCO.

+ Guides and collaborates with the CCO Board to establish mechanisms and policies for performance oversight of operations and initiatives in support of the Delegation Agreement and Management Services Agreement between CareOregon and the CCO.

+ Establishes and effectively executes both short-term and long-term operational strategies to achieve Columbia Pacific CCO’s objectives as documented in the annual CCO Strategic Plan.

+ Leads, guides, mentors staff (both direct and matrixed reports) to the highest levels of contribution and performance consistent with CCO operational efficiency and effectiveness.

+ Engages the organization and participates in continuous quality improvement initiatives, events and programs.

+ In partnership with CareOregon leadership, assures excellent service to members as measured by objective satisfaction surveys.

+ Oversee the development and implementation of a Community Health Improvement Plan.

Resource Management

+ Contributes to and monitors Value-Based Payment (VBP) contracts and other payment programs with individual regional clinics/clinic systems that support equitable and high-quality clinical outcomes.

+ Works with CareOregon leaders to establish and maintain fiscal policies, reporting and monitoring mechanisms, in collaboration with CareOregon leaders for sustainable CCO financial performance on an annual basis and over time.

+ Assures Columbia Pacific CCO’s proactive response to legislative and regulatory issues related to rate-setting, utilization and trend data to ensure appropriate revenue and long-term financial stability.

+ Develops and manages annual budgets in alignment with strategic planning and organizational priorities.

+ Ensures teams have sufficient resources to achieve the necessary performance targets and results.

+ Establishes organizational policies and initiatives to maximize achievement of CCO quality metrics and risk recapture by clinical partners.

+ Ensures that Columbia Pacific CCO’s long term strategy is in alignment with federal initiatives and policies.

Employee Supervision

+ Direct team(s) and establish team direction and goals in alignment with the organizational mission, vision, and values.

+ Identify work and staffing models; recruit, hire, and oversee a team to meet work needs, using an equity, diversity, and inclusion lens.

+ Identify department priorities; ensure employees have information and resources to meet job expectations.

+ Lead the development, communication, and oversight of team and individual goals; ensure goals, expectations, and standards are clearly understood by staff.

+ Manage, coach, motivate, and guide employees; promote employee development.

+ Incorporate guidance from CareOregon equity tools into people leadership, planning, operations, evaluation, budgeting, resource allocation, and decision making.

+ Ensure team adheres to department and organizational standards, policies, and procedures.

+ Evaluate employee performance and provide regular feedback to support success; recognize strong performance and address performance gaps and accountability (corrective action).

+ Perform supervisory tasks in collaboration with Human Resources as needed.

Organizational Responsibilities

+ Perform work in alignment with the organization’s mission, vision and values.

+ Support the organization’s commitment to equity, diversity and inclusion by fostering a culture of open mindedness, cultural awareness, compassion and respect for all individuals.

+ Strive to meet annual business goals in support of the organization’s strategic goals.

+ Adhere to the organization’s policies, procedures and other relevant compliance needs.

+ Perform other duties as needed.

Experience and/or Education

Required

+ Minimum 10 years’ experience developing, managing, or influencing managed care, health care policy or programs

+ Minimum of 5 years of Medicaid experience in a health plan or public agency setting

Preferred

+ Minimum 5 years’ experience in a supervisory position

+ Experience working in a highly matrixed organization and with external partners in complex collaborative structures or organizations

+ Master’s or bachelor’s degree in health policy, public health, health care administration, business administration, law, or related field

Knowledge, Skills and Abilities Required

Knowledge

+ Knowledge of state and federal Medicaid managed care program contractual requirements, regulations and statutes, including Oregon Health Plan health care laws and regulations

+ Understanding of the nature of governance; board obligations, responsibilities, roles, and duties; governance/director best practices

+ Understanding of healthcare industry structure/dynamics

+ Understanding of health plan financing, health care costs, health outcome measures such as HEDIS and CAHPS, and health plan operations, such as claims payment, customer service, medical management, and quality improvement

+ Understanding of Columbia Pacific CCO, including its market, vision/mission, strategies, management, operations, and financial structure

Skills and Abilities

+ Ability to build and strengthen relationships and a culture of trust

+ Ability to obtain and retain knowledge of:

+ Government regulations as they relate to the administration of the Medicaid program

+ The principles and practices of managed care and Coordinated Care Organizations

+ Plan benefits, the Prioritized List, systems and procedures, changes in Medicaid guidelines and regulations, changes in the health care services, changes in the legal/legislative arena that impact operations

+ Health care public policy issues

+ Comprehensive program planning and development, management, and evaluation skills

+ Ability to manage multiple tasks and coordinate work across multiple systems

+ Ability to work in a cooperative, informative, and proactive manner with the Oregon Health Authority, state legislators and Oregon’s Congressional delegation

+ Excellent research, writing, listening and verbal communication skills

+ Strong analytical and creative problem-solving skills

+ Effective public speaking/presentation skills

+ Ability to negotiate favorable outcomes, and build consensus

+ Budget management skills

+ A “service orientation” in working with the board chair, board committee chairs and directors

+ Willingness/ability to occasionally work irregular hours (e.g., evening meetings and weekend activities)

+ Ability to work effectively with diverse individuals and groups

+ Ability to learn, focus, understand, and evaluate information and determine appropriate actions

+ Ability to accept direction and feedback, as well as tolerate and manage stress

+ Ability to see, read, and perform repetitive finger and wrist movement for at least 6 hours/day

+ Ability to hear and speak clearly for at least 3-6 hours/day

+ Ability to operate a motor vehicle

Working Conditions

Work Environment(s): ☒ Indoor/Office ☒ Community ☐ Facilities/Security ☐ Outdoor Exposure

Member/Patient Facing: ☒ No ☐ Telephonic ☐ In Person

Hazards: May include, but not limited to, physical and ergonomic hazards.

Equipment: General office equipment

Travel: Requires travel outside of the workplace at least weekly; the employee’s personal vehicle may be used. Driving infractions will be monitored in accordance with organizational policy.

Work Location: Hybrid-Community 2 days/week

Candidates of color are strongly encouraged to apply. CareOregon is committed to building a linguistically and culturally diverse and inclusive work environment.

Veterans are strongly encouraged to apply.

We are an equal opportunity employer. CareOregon considers all candidates regardless of race, color, religion, sex, sexual orientation, gender identity, national origin, age, genetic information, disability, or veteran status.

Visa sponsorship is not available at this time.