VP, Medicare Health Services

Responsible for oversight and management of integrated health services within the medical management department which encompasses Population Health Management, Utilization Management, Case Management, Disease Management, Quality Management, Health Education and Medical Outreach for all VPHP regions with Medicare lines of business. Work collaboratively with the Chief Medical Officer to develop and implement processes to effectively manage clinical policies set by the Medical Management Department to meet healthcare cost and quality targets. Work with the Medicare Health Services team to develop and implement effective and efficient standards, protocols, processes, decision support systems, reporting and benchmarks that support ongoing improvements of clinical operations functions and promote quality, cost-effective health care for Virginia Premier Health Plan members. Meet annual healthcare cost and quality targets for the health plan. Responsible for effective working relationships with regulatory/community agencies, provider communities, hospitals, and departments within Virginia Premier to improve operations, member outcomes and health plan expansion through growth opportunities. Serves as part of the executive leadership team and has shared accountability for an integrated approach to meeting overall department and company goals.

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