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Job Title: Associate HPN – Mount Sinai Health Partners

Background

Mount Sinai is one of the largest U.S. health systems with a strong reputation for quality of care (17th ranked US academic medical center) and innovative research/education (17th ranked US medical school, >$400M annually in NIH-funded research). This reputation is important but it’s not enough. At Mount Sinai, we have a responsibility to make healthcare better, optimizing its value for patients, purchasers, and communities.

The health care industry has a number of problems. Chief among them is affordability as federal and state governments are unable to keep Medicare & Medicaid solvent, employers are stretched to pay for health benefits for their employees, and those employees struggle to afford increasing paycheck deductions and deductibles. In addition, the industry has historically set a low bar for customer service, earning some of the lowest satisfaction scores of any industry, eroding trust from stakeholders. In recent years, employers and labor unions have begun to solve these problems by contracting directly with vendors and select providers to optimize value.

Mount Sinai Solutions was created to collaborate directly with the purchaser to solve these problems. We have assembled Mount Sinai's clinical and population health assets into product offerings of high-quality care that are affordable and distinguish themselves via exceptional service. Our offerings include next-generation primary care at or near the workplace (“Health Centers”), centers of excellence for specialty care, and high-performance network (HPN) based health benefit plans, in partnership with health plans. Our team markets & sells these products directly to the purchaser – i.e., consumers, large employers, labor unions. We are looking for people to join our team who are passionate about solving these problems by developing a true system of care that can deliver market-leading value.

Role Summary

There is a multi-billion dollar addressable market opportunity in the New York City metro region from large employers and labor unions seeking to re-build their health benefits plans around high performance networks (HPN). Large employers (e.g. Walmart) and labor unions (e.g. SEIU Local 32BJ) are shifting away from benefit plans based on broad provider networks to alternatives based on curated HPNs with better outcomes. Competition to deliver these HPN-based benefit plans is intense from health plans (e.g. United Nexus, Anthem’s Blue HPN), health systems (Northwell Direct) as well as well-capitalized vendors (e.g. Centivo, Oscar, Collective Health).

Mount Sinai is piloting its HPN with a large NYC labor union, in partnership with a prominent local health plan. Our HPN includes a curated network of high-value Mount Sinai providers, programs to improve the health of members with chronic conditions, and an enhanced service model that solves any member problem. The HPN will deliver market-leading value by saving 15-20% on the total cost of care for customers while improving health outcomes and delivering best-in-market service (net promoter score of >50) for members.

The Associate of HPN Operations will report to the Lead of HPN Operations. The Associate's primary focus will be to organize and govern its associated day-to-day operations to ensure we deliver against customer expectations. The Associate will collaborate closely with the HPN leads and clinical and business stakeholders across the Mount Sinai Health System to (i) develop an operating plan for the HPN ensuring desired performance, (ii) implement the operating plan including training staff and measuring key success metrics, and (iii) establish a governance process to monitor key performance indicators, to improve results, and, in partnership with the HPN Lead, to report updates to customers and executive sponsors. Our goal is to deliver results for our pilot customer as well as to learn/adapt our operations to ready the HPN for launch to any customer starting in 2023.

Responsibilities

Network Operations– The Associate will work with the HPN Lead (commercialization team) to develop the HPN & be accountable to create and execute an operating plan that continuously improves a Mount Sinai-led network of physicians, facilities and other providers that participate in HPN programs sold to customers – highlights:

• Integrate the HPN seamlessly with other key functions: e.g. member services, billing, care mgmt., marketing
• Govern the HPN by tracking KPIs (partnering w analytics) & routine reviews of KPIs with HPN practices
• Curate the HPN by steering volume to best performing providers & improving/removing ”underperformers”
• Engage & contract with third-party providers that fill key access gaps and meet criteria for inclusion in HPN
• Collaborate with point persons in each department or practice to ensure access, e.g. block scheduling
• Gather and analyze patient and customer feedback to inform operations and incorporate customer feedback into day-to-day operations and governance process

Member Services– The Associate will work with the HPN Lead (commercialization team) and the SVP of Access Services to create and execute an operating plan for a ‘Member Services’ function dedicated to addressing any and all questions from members eligible for the HPN program – highlights:

• Hire and train a team of service reps (reporting to Access Services) dedicated to serving members of the HPN
• Ensure that this dedicated Member Services team is equipped with technology that enables KPI tracking
• Integrate the Member Services team seamlessly with other key functions: e.g. billing, care mgmt., marketing
• Integrate Member Services with other service teams contracted with the customer (e.g. health plan)
• Govern the Member Services team by tracking & routinely reviewing KPIs with leadership in Access Services
• Identify and implement processes to improve patient experience for HPN members

Condition Management– The Associate will partner with the HPN Lead (commercialization team) and the VP of Clinical Integration (population health team) to create and execute an operating plan for a ‘Condition Management’ function dedicated to improving health of members with chronic illnesses who are eligible for the HPN program – highlights:

• Develop programs for specific chronic illnesses that support HPN members to improve their health
• Hire and train a team of “care guides” (reporting to Pop Health) dedicated to serving members of the HPN
• Ensure that this dedicated Care Guides team is equipped with technology that enables KPI tracking
• Govern the Member Services team by tracking & routinely reviewing KPIs with leadership in Access Services
• Identify and implement processes to improve patient experience for HPN members

Product/Technology Strategy & Innovation- working in partnership with operations and HPN Lead, the planning and implementation of technology impacting the improvement of operations, Access and experience- highlights:

• Identify and propose product and technology improvements for providers, staff and patients to improve user functionality , increase access, improve patient experience
• Define and build analytics necessary to measure and closely monitor the effectiveness of projects while informing future iterations
• Leverage qualitative and quantitative learnings to develop a deep understanding for what is important to users (customers, doctors & partners, internal teams), and use that to drive the roadmap and help shape the overall product/technology strategy.

• Compile and present transparent product performance to key stakeholders
• Apply market & competitive analysis of market trends to guide evolution of product strategy

Qualifications

Education and Experience

• Bachelor’s Degree required; MBA preferred
• 3 years of professional experience in a fast-paced work environment
• Proven aptitude for process improvement; Certification programs and/or Master’s Degree in Business, Engineering, or related fields desired
• Experience at a leading management consulting firm, leading health care system, and/or high growth/scaled health care startups preferred
• Expertise in Microsoft Office Suite (PowerPoint, Excel, etc.)
• Experience in data analysis; Tableau experience highly preferred

Other Qualities

• Highly organized, structured, and detail-oriented in approach to leading teams and stakeholders
• Innovative thinker who can develop solutions where there are few precedents; comfortable with ambiguity
• Resilient approach that doesn’t dwell on setbacks, finding creative solutions to obstacles
• Passionate about improving health care to optimize care quality and service

Who We Are

Over 42,000 employees strong, the mission of the Mount Sinai Health System is to provide compassionate patient care with seamless coordination and to advance medicine through unrivaled education, research, and outreach in the many diverse communities we serve.

Formed in September 2013, The Mount Sinai Health System combines the excellence of the Icahn School of Medicine at Mount Sinai with seven premier hospitals, including Mount Sinai Beth Israel, Mount Sinai Brooklyn, The Mount Sinai Hospital, Mount Sinai Queens, Mount Sinai West (formerly Mount Sinai Roosevelt), Mount Sinai St. Luke’s, and New York Eye and Ear Infirmary of Mount Sinai.

The Mount Sinai Health System (MSHS) provides equal employment opportunity to all its employees and applicants for employment without unlawful discrimination on the basis of their actual or perceived race, creed, color, religion, national origin, sex, gender, gender expression, gender identity, age, disability, marital or parental status, sexual orientation, veteran, immigration, citizenship, or other protected status.

EOE including Veterans and Disabled

Compensation

The Mount Sinai Health System (MSHS) provides a salary range to comply with the New York City Law on Salary Transparency in Job Advertisements. The salary range for the role is $72,473.00 - $108,709.00 Annually. Actual salaries depend on a variety of factors, including experience, education, and hospital need. The salary range or contractual rate listed does not include bonuses/incentive, differential pay or other forms of compensation or benefits.