VP - Clinically Integrated Networks - Reno Nevada

Company: UHS
Location: Reno, Nevada
Posted On: 04/25/2025

Responsibilities

Prominence Health is a value-based care organization bridging the gap between affiliated health systems and independent providers, building trust and collaboration between the two. Prominence Health creates value for populations and providers to strengthen integrated partnership, advance market opportunities, and improve outcomes for our patients and members. Founded in 1993, Prominence Health started as a health maintenance organization (HMO) and was acquired by a subsidiary of Universal Health Services, Inc. (UHS) in 2014. Prominence Health serves members, physicians, and health systems across Medicare, Medicare Advantage, Accountable Care Organizations, and commercial payer partnerships. Prominence Health is committed to transforming healthcare delivery by improving health outcomes while controlling costs and enhancing the patient experience.

Learn more at: https://prominence-health.com/

Job Summary: VP, Clinically Integrated Networks (CIN) leads and manages the implementation and national expansion of CIN value-based program strategy and relevant client service models consistent with the goals of Prominence Health and Universal Health Services. This role is ultimately accountable for clinically integrated network development and CIN value-based program outcomes, both quality and financial, as well as business alignment efforts targeted toward expansion of the UHS/Prominence Health national value-based care CIN footprint. The incumbent will champion outcomes-based initiatives and market-alignment activities contributing toward goal of highly integrated health care systems across the nation, within current UHS markets and through expansion to new locations. This individual will play a key role in representing UHS CINs powered by Prominence Health as the value-based engine of UHS to internal stakeholders and external partners.

VP, Clinically Integrated Networks will be responsible for establishing and implementing outcomes-based programs and necessary supporting client service models at a national level tailored to individual market needs, demonstrating proven results through population health centric models and collaborating with internal and external key executives to ensure that value-based contracts align with the overall Company's strategy.

This incumbent is a key part of Prominence's strategic imperative to achieve its share of care and UHS physician alignment goals, as well as the goal of building the provider capacity necessary to support UHS's clinical integration strategy through engaged, value and performance based oriented providers across the country. As a member of Prominence's senior leadership team, the incumbent will be accountable with other senior leaders for achieving Prominence's financial, quality, and service goals. In addition, the incumbent will represent Prominence CINS in UHS workgroups working on clinical integration and population management.

About Universal Health Services:

One of the nation's largest and most respected providers of hospital and healthcare services, Universal Health Services, Inc. (UHS) has built an impressive record of achievement and performance. During the year, UHS was again recognized as one of the World's Most Admired Companies by Fortune; and listed in Forbes ranking of America's Largest Public Companies. Operating acute care hospitals, behavioral health facilities, outpatient facilities and ambulatory care access points, an insurance offering, a physician network and various related services located all over the U.S. States, Washington, D.C., Puerto Rico and the United Kingdom. www.uhs.com

Qualifications

Qualifications and Requirements:

• Master's Degree in Business Administration, Finance, Health Care Administration, Management or related field preferred.
• Minimum 15 years' healthcare management experience working with both fee-for-service and value-based contracting.
• Experience in value-based reimbursement methodologies and understanding the impact of financial results.
• Demonstrated ability to develop and execute a provider network strategy that leads to clinical integration, value-driven networks.
• Extensive experience with risk and value-based reimbursement models for physicians and hospitals and ability to communicate these models to providers and Prominence staff.
• Experience in working with physician profiling software such as Verisk and Crimson.
• Extensive experience with the full range of network development, ranging from selecting providers, contracting, credentialing, provider feedback, to provider services.
• Demonstrated ability to build a highly functioning team and to mentor direct reports.
• Experience with NCQA processes.
• Experience with Commercial, self-funded, and Medicare Advantage network requirements.
• Proven ability to foster collaboration between divergent stakeholders.
• High degree of credibility with key stakeholders based on past accomplishments.
• Experience in negotiating complex provider reimbursement arrangement.
• Proven ability to drive organization through cultural change, focused on individual accountability and performance.
• Solid understanding of health plan key financial drivers.
• Excellent analytical skills applied in selecting and profiling providers.
• Solid understanding of medical coding terminology used by physicians and facilities.
• Ability to effectively communicate in English, both verbally and in writing.
• Excellent communicator who is equally comfortable with external stakeholders as well as internal stakeholders.
• Strategic but practical thinker that can take concepts from its initial stage through implementation to administration.
• Ability to establish and maintain strategic relationships with providers and payors.
• Service excellence orientation toward external and internal stakeholders.
• Ability to interpret complex contract information.
• Technologically adept to drive efficiency and effectiveness through Social Media, web portals, and workflow automation.
  EEO Statement
  
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