Southwestern Health Resources was established in April 2016 as a unique partnership between the founding entities, UT Southwestern Medical Center, a public academic medical center, and Texas Health Resources, a private faith-based non-profit health system, based on a shared commitment to create a highly differentiated value proposition in both quality and total cost of care for consumers, purchasers, patients and physicians. A cornerstone of Southwestern Health Resources is a clinically integrated network of independent and employed physicians, including the employed faculty physicians of UT Southwestern, the employed physicians of Texas Health Physician Group, and independent community primary care and specialty care physicians. The integrated network builds on more than 50 years of collaboration between the two institutions to improve the health of North Texans.

Southwestern Health Resources includes 29 hospital locations and more than 5,000 physicians located throughout North Texas in its network. With over 650 points of access to care, this provides for higher value and allows patients to access services across a full continuum of medical needs. The network serves people across 16 counties in North Texas. SWHR coordinates care for more than 700,000 patients, aligned with commercial health care plans and Medicare programs, along with more than 13,000 Medicare beneficiaries enrolled in its Care N' Care health plan. It also provides Population Health Services through clinical and quality data along with analytic services necessary to support the physician-driven clinical decisions.

Position Summary:

Reporting to the Senior Executive Vice President / Chief Financial Officer of Texas Health Resources and the Executive Vice President for Health System Affairs of UT Southwestern, the Senior Executive Officer SWHR (SEO) will have ultimate responsibility for operationalizing and executing the strategic plan for SWHR including a payer and direct-to-employer strategy that is aligned with the companies' organizational goals and enables the organizations to succeed in a dynamic reimbursement environment. This executive will have oversight of the entirety of SWHR, including the CIN (clinically integrated network), Care N Care health plan and all managed care functions across both UT Southwestern and Texas Health Resources, representing $7.5 billion in base rate and at-risk contracted revenue through SWHR.

This leader will manage the relationships with and earn the respect of traditional managed care organizations as well as consultants/brokers, and employers. The SEO will be expected to coordinate efforts with the leaders and governance of hospitals, physician groups and parent system population health services, which are part of the SWHR organization, and ensure that the best interests of both partners - representing both community-based hospitals and academic medicine - are served in contracting functions on behalf of the whole.

The SEO will interface with key leaders across the organization to effectively coordinate contracting for healthcare products and services. The successful candidate will be responsible for creating and leading a strategy that optimizes revenue while assessing both fee-for-service and value-based payment methods, ranging from upside-only risk to full capitation, evaluating new market offerings such as limited and tiered network products and considering new market opportunities like telehealth and national and international purchasers, as well as direct to employer relationships. This leader will oversee payment design for the Physician Network, Care N' Care insurance company and Hospital Network, as well as the two parent organizations. The successful candidate will serve as a steward of fiscal resources, with the primary mission to achieve the revenue of SWHR and its affiliate organizations to ensure their ability to deliver high quality, high value care to the communities they serve.

The SEO will ensure a robust and sufficient physician network ranging from primary and preventative care to highly specialized tertiary and quaternary services and spanning the entire continuum from ambulatory outpatient services to the inpatient acute care setting. Toward that end, the SEO will have responsibility for developing the population health services capabilities that allow SWHR to drive continued improvement in the quality and the value of care provided.

Broadly cast, the SEO is responsible for developing the network capacity and its internal operations making it the destination of choice for physicians. The SEO will be expected to work in a coordinated and collaborative manner with the leadership of the two partners to ensure that the overall strategies and operations are effectively bound with individual organizational strategic goals.

Key relationships and accountability

This position will direct accountability for SWHR operations including care coordination, CNC health plan and MA ops, network business development, network physician engagement, physician engagement, patient experience and quality, risk adjustment and utilization management. The SEO will collaborate with THR and UTSW leaders on SWHR administrative departments including legal, compliance, accounting, marketing, analytics, facilities, IT, and HR.

Key relationships will also include SEVP/Chief Experience Officer of THR, VP/Chief Strategy Officer at UTSW, EVP of Business Affairs at UTSW, and other senior executives of the founding partners. The SEO has formal accountability to the Board of the SWHR CIN, co-chaired by the CEO of Texas Health Resources and the President of UT Southwestern. While UT Southwestern serves as the majority owner of the CIN (at 51%), SWHR is an equal partnership between UT Southwestern and Texas Health Resources. The successful SEO will effectively advance both the collective and individual needs of the two partners. Most importantly, the SEO will be expected to drive performance through effective leadership, operating expertise, and innovative solutions and initiatives.

Responsibilities and Duties:

• Partner with senior leadership to devise payer strategies that align with delivery system requirements and organizational goals and ensure market access, improved care quality and financial strength for SWHR, its parents and participating providers.

• Advance the organizations' value-based payment strategy through the optimization of existing programs and development of new risk-based reimbursement models and innovative insurance products featuring SWHR's providers.

• Oversee and recommend negotiation plans, which will establish negotiating parameters that are aligned with the goals, strategies and objectives of SWHR and its parent organizations and optimize value in the care it delivers.

• Partner with internal constituencies to develop strategies that increase competitiveness in the local market while leveraging volumes and strategic relationships.

• Collaborate with clinical leaders to develop quality-based metrics and contractual incentives.

• Ensure appropriate representation to the payer and healthcare purchaser market on behalf of SWHR and its affiliated hospitals, ancillary providers, independent practice associations and physician groups.

• Build and maintain positive ongoing relationships with all healthcare purchasers, with the objective of maximizing market share for SWHR-affiliated members.

• Oversee managed care contracting and business implementation strategies with commercial and governmental insurance companies, consultants/brokers, and employers.

• Ensure rigorous prospective modeling and routine financial reporting to ensure stakeholders have reliable information necessary to make informed decisions.

• Work closely with parental business offices to ensure contractual arrangements support efficient collection efforts in all payer segments. Monthly review of payor performance to drive interim payor engagement for identified issues, as well as during contract negotiations.

• Oversee healthcare purchaser community and SWHR-affiliated organization relationships to provide market intelligence and customer feedback, as well as facilitate testing of new ideas, strategies and tactics with the healthcare purchaser community.

• Oversee CIN and CnC operations to ensure alignment of SWHR and parental strategies are incorporated into agreements, in alignment with organizational goals and strengths.

• Assess new and prospective regulations to determine impacts on contracts and reimbursement, and take appropriate action.

• Understand and advance specialty and parental growth programs (in that, transplant, oncology, etc.) to ensure appropriate reimbursement, especially those programs that create unique value for the communities served.

• Provide system-wide payer relations management in order to develop strategic and tactical operating plans that support the achievement of the financial and strategic objectives of SWHR.

• Support the development of key indicators to monitor payer and healthcare purchaser relations activities. Manage all key indicators to ensure target compliance.

• Oversee preparation of financial and statistical analysis and reporting for all payer and healthcare purchaser contracting.

• Develop, motivate and mentor a management team to its highest performance. Work to effect positive change. Instill accountability to create a high-performing team.

• Create strategic alliances with key internal and external groups to maintain or create a competitive advantage for SWHR and its affiliates.

• Responsible for oversight and management of the Physician Network.

• Responsible for Physician Network development including recruitment and credentialing.

• Accountable for clinical, operational and financial performance of the network in all risk contracts.

• Responsible for Physician Network operations and care model development.

• Promotes a structure for the provision of high-quality care in a sound fiscal environment.

• Formulation and implementation of an overarching strategy for risk relationships with governmental and commercial payers.

• Responsible for population health activities including a comprehensive portfolio of clinical and support services to enable physician success such as case management, utilization management, quality, predictive analytics and performance measurement/management/reporting.

• Oversee all CIN capital budgets, operating budgets and strategic plans within parameters established by the SWHR board.

• Create a common team and shared culture of performance excellence that is accountable for delivering the portfolio of services required for the success of the CIN.

Individual must be able to perform each essential duty satisfactorily. Reasonable accommodations may be made to enable individual with disabilities to perform the essential functions. This role requires the ability to solve problems, think outside-the-box, and be resourceful; must be result-oriented, a quick learner and self-starter. Comfortable working in complex and matrix organizations. The requirements listed below are representative of the knowledge, skill, and/or ability required to build SWHR's culture for action.

• Bachelor's degree in business, health care administration, finance, or related fields required.
• Master's degree in business, health care administration, finance, or related fields preferred.
• 10 years' experience negotiating complex managed care contracts involving value-based payments with payer organizations, preferably with an integrated health system which includes acute care, physician and sub-acute care operations and both academic and community hospitals required.
• Experience working with consultants/brokers, employers and direct-to-employer products preferred.
• Specific experience and strong track record in developing and executing innovative strategies to address market issues in healthcare including via payer arrangements.
• Demonstrated ability to articulate a vision and generate necessary consensus behind implementation through exceptional influencing skills. Is results driven and comfortable implementing and driving change in a highly matrixed environment.
• Strong industry knowledge related to value-based care, payment innovation, and provider collaboration.
• Experience conducting significant negotiations.
• Deep understanding of competitive landscape and industry trends in topics such as physician compensation redesign, patient-centered medical homes, full-risk capitation, bundled payments, and commercial and government ACO programs.
• Ability to think critically, understand complex concepts and quantitative analyses, synthesize information and make good judgments. Deep understanding of the analysis of data and information, with the capability to support the design, execution and deployment of effective performance dashboards and metrics.
• Excellent oral, written, and interpersonal communication and persuasion skills required.
• Capable of functioning in ambiguous environments and handling multiple and diverse tasks simultaneously.