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Page 1: Non-Union Exempt Position Summary JOB CODE: POSITION TITLE: Chief Operating Officer ...€¦ ·  · 2017-08-14POSITION TITLE: Chief Operating Officer DATE: August 2017 DIVISIONS:

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Non-Union Exempt Position Summary

JOB CODE:

POSITION TITLE: Chief Operating Officer DATE: August 2017

DIVISIONS: Operations

REPORTS DIRECTLY TO: Chief Executive Officer

POSITION PURPOSE: (Why does this position exist?)

The Chief Operating Officer (COO) shall contribute to the strategic goals of Fulcrum Health and drive operational performance to demonstrate on its mission by delivering high value health care networks, products and support services. This role shall contribute to the positioning of Fulcrum Health as a market leader in leveraging physical medicine to transform health care. The COO shall hold primary accountability for directing and overseeing all operational activities of Fulcrum Health including Network Management and Provider Contracting, Health Services, Business Development, Vendor Management, Research and Development, Implementation and Evaluation. S/he will assess the current operations and align the unit with the company’s overall goal, which is to leverage physical medicine to transform healthcare. The COO will work in a dyad relationship with the Chief Clinical officer and cross-functionally with internal teams to driver operational excellence. The COO reports directly to the Chief Executive Officer of Fulcrum Health and is a member of the senior management team. The COO shall demonstrate the values that comprise the culture of the organization and work with the CEO on culture setting and activities related to change management according to strategic direction. This position will support the Quality Committee of the Board of Directors.

ACCOUNTABILITIES: (Key roles, responsibilities & functions for this position)

Network Management and Provider Contracting • Provide oversight of ongoing contract and relationship development that improves both the clinical and

quality performance of the network while supporting market expansion into new geographies. • Lead cross functionality across business units to develop and manage provider contracting and

management efforts to achieve quality, positive value-based arrangements, and strategic business development objectives for the entire organization.

• Provide oversight of ongoing contract and relationship development that improves both the clinical and quality performance of the network while supporting market expansion into new geographies.

• Provide oversight of Credentialing function to ensure network quality.

Page 2: Non-Union Exempt Position Summary JOB CODE: POSITION TITLE: Chief Operating Officer ...€¦ ·  · 2017-08-14POSITION TITLE: Chief Operating Officer DATE: August 2017 DIVISIONS:

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Health Services • Establish quality control mechanisms to continuously drive operational efficiency through process

redesign and data-driven analysis. • Responsible for assessing all operational areas, focusing on identifying metrics and dashboards to drive

the quality, accuracy, throughput, service levels, and efficiency of all operational processes to ensure scalability of growth to 2 million members and beyond.

• Assist in strategic oversight of enterprise information systems to support clinical and business operations, and achieve more effective and cost beneficial enterprise-wide IT operations. Lead program development strategy to ensure that Fulcrum’s capabilities to serve members across the continuum of health, chronic disease and acute care are translated into products and services appealing to purchasers. This includes Utilization Management.

• Responsible for regulatory compliance and accreditation activities.

Business Development

Develop and implement effective short- and long-term strategies, and establish objectives and plans required for Fulcrum’s ongoing growth and success. Provide leadership necessary to ensure the organization’s strategic plan is translated into clear, tactical goals and objectives that result in consistent and timely progress toward achievement of performance objectives.

Participate and lead where appropriate with the CEO key strategic discussions around collaboration and initiatives related to population health with key stakeholders.

• Participate in sales and account management process as executive lead for Operations which includes active role in sales & RFP strategy, finalist presentations, and ongoing account management interactions. Effectively manage escalated client situations to a positive result, anticipating problems, working with key internal constituents and developing contingency plans.

Research and Development • Identify and assess emerging trends and conditions to educate the executive leadership team of

potential scenarios that could impact the strategies, total cost of care objectives, and overall performance of the company

• Lead program/product development strategy to ensure that Fulcrum’s capabilities to serve members across the continuum of health, chronic disease and acute care are translated into products and services appealing to purchasers.

Implementation and Evaluation • As part of the strategic planning process, implementation, and monitoring of strategic plans specific to

changes in medical care and trends in provider contracting and clinical operations. Ensure goals and objectives are implemented, and executed to successfully manage medical costs.

People Management/Mentorship • Develop and foster strong working relationships and communication at all levels of the company to

ensure timely implementation of new strategies, and coordinate implementation of corrective strategies to resolve problems or situations that may arise. Problem-solve issues that are barriers to expected results.

Page 3: Non-Union Exempt Position Summary JOB CODE: POSITION TITLE: Chief Operating Officer ...€¦ ·  · 2017-08-14POSITION TITLE: Chief Operating Officer DATE: August 2017 DIVISIONS:

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Recruit, select, and retain highly qualified professionals. Provide the leadership necessary to transform

functional areas into motivated, productive, and cohesive teams through open communication and

delegation of responsibilities and authority. Mentor/guide the team in a way that promotes strategic

alignment and integration, operational flexibility and high levels of engagement.

• Guide and direct subordinates in their personal and professional development. Develop and implement a succession planning process to assure stability and continuity of key personnel.

• Assigns appropriate resources as necessary and provides strategic direction to operational departments to support the goals of the organization in a streamlined and efficient manner, and ensure that they work collaboratively to make performance improvements on functions that cross departments.

• Other duties as assigned by the Chief Executive Officer. REQUIRED QUALIFICATIONS: (Minimum qualifications needed for this position)

8 years in senior leadership with a minimum of 3 years health plan management leadership experience directly related to developing and/or leading programs focusing on medical management as measured by cost, quality and satisfaction outcomes.

Skilled at establishing and maintaining effective interpersonal relationships with all level of leaders, physicians and other providers, employees and members/customers

Demonstrated success in developing business strategy, critical decision making and leading business operations

Proven success in building and mentoring effective leadership teams, and demonstrated ability to lead people and get results through others

Leadership qualities, motivational skills and excellent communication skills, oral and written

Ability to engage and convene stakeholders, community partners, providers, researchers and patients as advisors to innovate within value based care and creating accountable communities for health.

Public policy and advocacy leadership disseminating evidence based information to inform health policy in support of value based care reimbursement and public health.

Skilled at infrastructure development, management and maturation to support operations and research activities.

Experience in providing oversight for informatics and technical environments (datamarts, meta data management, data governance) to support measurement reporting and analytic capabilities to inform business development and innovation.

Able to excel in a high powered, fast paced, high growth environment

Strong quantitative skills and the ability to understand and communicate complex financial, medical, research methodologies, informatics and technical information to varied audiences.

Strong understanding of health plan NCQA accreditation and regulatory requirements

Demonstrated ability to work collaboratively with a diverse workforce

Demonstrated ability to lead strategy development and execution

Successful track record of health plan leadership, execution and delivery

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PREFERRED QUALIFICATIONS:

Masters degree in business or health care administration.

Certification in Health Care Quality

Certification in Research Compliance

DIRECT/INDIRECT REPORTS: Number of direct reports and titles: 6 direct reports Vice President of Operations Director of Clinical Operations Manager of Credentialing Quality Improvement Specialist Project Manager Support Person Number of indirect reports: 3-6 indirect reports