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SVP, Market Operations and Growth/ President,…
- Apex Health Solutions (Houston, TX)
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Job Title: SVP, Market Operations and Growth/ President, Unity Health Partners; Supervisor: President, Apex Health Required License(s)/ Certification(s): None Required FLSA Status: Exempt Summary: The Senior Vice President of Market Operations role at Apex Health will be responsible for the implementation, performance and growth of all Apex customer engagements, including core Southeast Texas networks and new health system and market expansions. The role will be a part of the executive leadership team of Apex Health and report directly to the company President. The SVP of Market Operations will be responsible for driving operational excellence, market expansion and strategic development. This position will be responsible for meeting performance targets while identifying and executing opportunities for growth through new partnerships and service line development. This role requires a balance of operational rigor, strategic foresight, and relationship management to drive sustainable growth. The President of Unity Health Partners role will lead the overall strategy and operations of Unity Health Partners, the risk-bearing IPA in the Greater Houston / Southeast Texas market. Unity is owned by three parties – Memorial Hermann Health System, Apex Health and Independent Physicians in the Houston market. Unity currently contracts with the Memorial Hermann Health Plan under professional capitation and includes both employed (Memorial Herman Medical Group) and contracted physicians. Unity is expanding its offerings by including additional MA payers and CMS ACO value-based programs to participating physicians, and also is expanding its physician incentive payment model to attract new physician participation. The role of the President of Unity Health Partners will oversee the operational and financial performance of all physician-assigned membership and lead the expansion of the network across the SETX market. Essential Duties and Responsibilities include the following. Other duties may be assigned . · Build and manage high-performing teams focused on network operations and growth, burden of illness capture, HEDIS/STARs quality gap closure, claims expense management and operational efficiency · Develop and monitor KPIs related to quality, utilization, patient outcomes, and financial performance · Partner with physician leaders to ensure operational processes support high quality, patient-centered care · Develop and execute market growth strategies, including payer partnerships and network development · Identify and evaluate opportunities for strategic alliances to expand the organization’s footprint · Provide P&L leadership, direction and operational oversight to health plan management teams to ensure the organization’s strategic plans are translated into tactical goals and objectives · Drive consistency and optimization across health plan markets via proactive collaboration · Oversee all payer and provider contracting strategies to ensure sustainability and alignment with organizational objectives · Expand relationships with new health systems and deploy Apex Health’s value-based services and support model to new markets · Strengthen the Unity and new health system customers’ physician and provider network, ensuring network adequacy access and performance standards meet regulatory requirements · Collaborate with clinical and operational leaders to implement quality improvement programs, sustain high STAR ratings, and ensure continuous monitoring of quality metrics · Foster a culture of continuous improvement and innovation Candidate Qualifications: Education · Degree in Business Administration, Health Administration, Public Health, or other relevant field · MBA or Master’s degree in Finance is preferred Skills · Strong communication and leadership skills · Deep understanding of healthcare finance, risk adjustment, and value-based care payment models · Team building and recruiting · P&L experience in managed care or provider risk business · Physician group value-based contracting and alignment model design · Risk and quality improvement programs for employed physicians · Network development and provider contracting experience, including professional, inpatient and post acute/ancillary providers · Strong negotiation, relationship management, and strategic planning abilities · Expertise in operational execution and performance improvement Experience · Minimum of 10-12 years of progressive experience in healthcare delivery, managed care, or value-based operations · Managed care P&L experience strongly preferred · Proven success in network contracting, risk-based performance management, and medical cost optimization · Demonstrated experience improving STAR ratings and quality performance metrics About Apex Health Solutions Apex Health is a tech-enabled management services organization transforming how health systems unlock value from their physician networks and succeed in value-based care. More than a consultant, Apex embeds as a long-term partner to drive sustainable performance across provider enablement, quality, network growth, and value-based care. With proven success at leading health systems, Apex helps clients preserve local control over care delivery and financing, rather than outsourcing it to national insurers.
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