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Hospital Relationship Manager

at HMSA

Posted: 10/2/2019
Job Reference #: 5000512459006
Keywords:

Job Description

Employment Type

Full-time

Exempt or Non-Exempt

Exempt

Job Summary

This position serves as the principle HMSA contact point in facilitating the assigned Hospital/Health System (Provider) and/or broader provider network activities for all lines of business. This position will be responsible for the successful coordination and facilitation of all touch points between HMSA and Provider, as a client and service organization, along with the achievement, improvement and maintenance of HMSA's strategic goals. This involves knowledge and ability including implementation and administration of all the contractual relationships, financial models and HMSA business matters with the Provider.

This position utilizes innovative way to explores and nurtures improvement opportunities, guides provider partner to gain insights into their organization/health care delivery system. Through data analysis, monitoring performance against metrics, interpersonal skills, and leading an integrated, collaborative service team consisting of internal and external partners, this position will implement a Provider-centric plan to achieve our mutual goals to provide our members with quality care and continue to build a sustainable health care model. This requires extensive knowledge of the health care industry and applying new foundational principles as the knowledge base for cost effective quality improvement.
 
Job is required to work primarily from home or in a mobile office environment and infrequently at various unassigned workstations located throughout applicable HMSA department(s) mainly for in-person and on-site meetings with internal contacts. Parking validation will be provided on an occasional and transitory basis for approved business needs.

Minimum Qualifications

  1. Bachelor's Degree and five years related work experience; or equivalent combination of education and related work experience.
  2. Excellent verbal, written, presentation and group facilitation skills.
  3. Strong critical thinking skills.
  4. Effective leadership and project management skills.
  5. Strong research, development and implementation skills.
  6. Job is required to work primarily from home or in a mobile office environment and infrequently at various unassigned workstations located throughout applicable HMSA department(s) mainly for in-person and on-site meetings with internal contacts. Individuals will be provided the ability to access HMSA's information and systems from mobile and computing devices (i.e. laptops, smart phones, and home computers).
  7. Must have valid driver's license, access to an automobile with current license, registration and no fault insurance. Requires safely operating an insured automobile for travel to off-site locations to conduct and accomplish business related activities
  8. Neighbor Island travel with some overnight stays required.

Duties and Responsibilities

  1. Works closely with the Provider to develop, implement and maintain strategic initiatives to deliver quality care, improved access for HMSA members and to build a sustainable health care system by bending the cost trend across all lines of business.
    • Collaborate in setting the strategic direction for the business relationship between HMSA and Provider.
    • Utilize the quality improvement principles and subsequent related high-leverage changes in supporting the Provider in establishing its overall improvement aim and tests of change.
    • Assess, document, and report progression of assigned Provider from both a quantitative and a qualitative perspective.
    • Coordinate with HMSA Integrated Health Management Services and other Provider Service team members to develop and carry out action plans with provider integrated service teams to achieve defined goals and complete deliverables.
  2. Lead efficient, effective collaborative meetings with the executive leadership of the Provider and HMSA stakeholders. Manage all aspects of the provider relationship to include management of hospital quality programs, payment transformation and other strategic initiatives. Role model these skills in order that improvement team leaders will also be able to effectively manage improvement team meetings with increasing independence over the course of time.
    • Identify available external resources, such as consultants and group learning opportunities, to meet specific needs which extend beyond those that are met by the Provider Network and develop arrangements, working with HSD/PS Leadership and other functional areas within HMSA to make such resources available to all PO's.
    • Support provider team members in ongoing education on innovative principles and interventions in the health care to improve cost, quality, access and health.
    • Lead service teams in support of the on-going relationship with the Provider
    • Provides effective and actionable market intelligence with regard to the health care community.
  3. Plan and implement multi-level, cross departmental programs and projects with guidance from executive sponsors and subject matter experts. Manage deliverables and timelines including gathering business requirements, research and analysis and ongoing assessment. Assemble and lead teams composed of participants in HMSA and other HMSA partners to support the strategic initiative. Regularly work with data analysts to conduct analysis of clinical data, including medical claims, Electronic Medical Record data and utilization data to identify trends. Translate findings and outcomes and recommend strategies for early intervention and health/disease management, new programs, workflow and operational improvement activities. Assist clinic in facilitating changes and improvements based on the data.
  4. Establish, implement and revise all strategies to achieve cost, quality, health and access goals. Ensure reviewed and updated as necessary. Participate in contract negotiations and development of goals and deliverables.
  5. Work with HMSA management, HMSA Medical Director and other HMSA staff and external partners to ensure that Provider meets goals and standards. Effectively and actively manage and direct prioritization and resolution of all issues related to Provider in a timely manner effectively and collaboratively working through all functions and levels of HMSA. This is not simply acting as a pass-through but requires active engagement when necessary.
  6. Maintain collegial relationships with internal cross-functional teams and external partners including, but not limited to, collaborating organizations and vendors.
  7. Assist with the development and management of the annual unit plans and budgets.
  8. Perform other duties as needed.