DescriptionSHIFT: No Weekends
Pacific Partners Management Services (PPMSI) is a managed services organization formed in 1997 with administrative offices located in Foster City, CA. We provide services to IPAs in the Santa Clara and Monterey Bay areas. Our managed care and ACO services support approximately 1,000 independent physicians and include executive management, full financial services, utilization management, quality improvement, credentialing, contracting, claims processing and provider and member network services.
PPMSI is part of HCA Physician Services Group (PSG), the physician and practice management solution for the Hospital Corporation of America (HCA). PSG operates more than 750 practices, Urgent Care Facilities, and partners with HCA’s 165 hospitals to structure employed provider programs, professional service agreements, and joint ventures that offer the communities we serve high quality, cost effective care. We manage a collection of highly motivated and innovative leaders who are committed to excellence in every aspect of their career.
We offer an excellent benefits package, competitive salary and growth opportunities. Join our team and share your skills and talents with the nation’s largest private provider of healthcare services.
Reporting to the CEO, the Vice President of Operations & General Counsel is responsible for organizing, directing, planning, and evaluating all corporate operations, including but not limited to corporate and health plan contracting, contract compliance, human resources, claims and HIPAA compliance, capitation allocation, physician contracting and reimbursement, credentialing, and shared risk reimbursement.
Works closely with the Chief Financial Officer to achieve the goals of the corporation. Directs, administers, and coordinates the activities of the organization in support of policies, goals, and objectives established by the Chief Executive Officer and Board of Directors by performing the following duties personally or though subordinate managers.
Directs the formulation and implementation of policies, procedures and standards.
Corroborates on the design, implementation and functions of the PPMSI IS system with the IT Director to ensure that the IS system supports functionally and data requirements of all PPMSI departments.
Maintains knowledge of current trends and developments in the managed care/claims field by reading appropriate journals and other literature and attending seminars conferences.
Guides and directs management in the development, production, promotion, and financial aspects of the organization’s products and services.
Directs the preparation of short-term and long-range plans and budgets based on broad corporate goals and growth objectives.
Oversees managers who direct department activities that implement the organization’s policies.
Implements programs that meet corporate goals and objectives.
Creates that structures and processes necessary to manage the organization’s current activity and its projected growth.
Maintains a sound plan of corporate organization, establishing policies to ensure adequate management development and to provide for capable management succession.
Develops and installs procedures and controls to promote communication and adequate information flow within the organization.
Bachelor’s degree or equivalent experience in Accounting, Health Administration, or Business required, with a MBA or MPH preferred.
Ten years health care management or claims related experience with at least five years managerial experience in order to effectively direct and manage activities of the assigned managed care departments.
Professional knowledge of claims practices, theories and management required.
Experience working in a start up or development environment is desirable with demonstrated ability to show initiative.
Employs high level analytical, statistical, team building, and communication skills.
A strategic thinker with a broad understanding of the healthcare marketplace and potential future delivery options, who is capable of implementing innovative programs to further the business objectives of the organization.
Ability to interpret the impact of regulatory changes on the enterprise as well as conceptualize processes to effectively operate in the changing healthcare environment.
Has a demonstrated track record of developing trusting and successful business relationships.