Chief Executive Officer

Transcription

1 Chief Executive Officer Physicians Health Plan Lansing, Michigan A Position Profile

2 Physicians Health Plan P... hysicians Health Plan (PHP) began in 1980 when Sparrow Health System and a group of visionary physicians began developing mid-michigan s first broad-based independent practice association (IPA) model HMO. In 1982, PHP s first products were introduced to the market. Today, PHP remains a subsidiary of Sparrow and has more than 3,100 practitioners and 31 hospitals participating in its provider network. Physicians Health Plan provides high-quality healthcare coverage to more than 70,000 members and 400 employers across Michigan. The Sparrow affiliate has been recognized as Michigan s best health plan for customer service. It has also been ranked as one of the nation s best healthcare plans by NCQA. Mission To improve the health status of our members by facilitating access to quality, compassionate, accessible, and cost-effective health services through organized health delivery systems. Vision To be the premier health financing organization, known for its ability to improve the health status of its members and for its service, quality, innovative, and cost-effective financing solutions for employers, individuals, purchasers, and governmental agencies. Health Plans Whether it s an individual searching for health insurance or an employer in the market to cover the workforce, Physicians Health Plan has a product that s right for everyone. Its award-winning customer service and commitment to quality are key reasons why insurance producers and healthcare providers love to team with PHP. Individuals Physicians Health Plan offers a variety of health plans, each providing different benefits and options that fit the needs of individual members or groups. 01 Healthcare Exchange. The federal Patient Protection and Affordable Care Act will bring big changes to Michigan s health insurance marketplace. Among them is an online health insurance exchange that began operating January 1, It s a place where individuals and small groups can compare health insurance plans and apply for coverage.

3 Physicians Health Plan FamilyCare/Medicaid. PHP FamilyCare is a Medicaid program offered through the state of Michigan and backed by Physicians Health Plan. The program offers benefits that will provide health coverage to children, families, pregnant women, the elderly, and people with disabilities. Services include preventive care, immunizations, screening and treatment of health conditions, doctor and hospital visits, as well as vision and dental care. Individual Plans. PHP holds an open enrollment for individual coverage from October 1-31 each year. Coverage becomes effective on November 1 of that year. The first monthly premium is payable at the time of the application. Healthcare Solutions for Businesses PHP offers employers a variety of plans so businesses can find one that best suits their needs and budget. It also tailors plans to accommodate special circumstances. All of PHP s products share one advantage: they are locally owned and managed, ensuring receipt of prompt and efficient service from PHP employees who understand the marketplace. HMO/POS. PHP s original healthcare product has been keeping members healthy for more than 30 years. In that time, PHP has developed a reputation for assisting members and their providers with managing their care. PHP s HMO (Health Maintenance Organization) product has a broad network in mid-michigan. Members have the freedom to see any provider within the PHP service network without a referral. PHP s POS (Point of Service) product allows employees to see any provider they choose, in network or out of network. PHP also offers several plans compliant with the Mental Health Parity Act and Addiction Equity Act and that also work well with health reimbursement arrangements. PPO. PHP s PPO (Preferred Provider Organization) insurance plans, available to employers located anywhere in Michigan, give employees the freedom to see the providers they want at a low cost. High-Deductible Health Plan. A high-deductible health plan (HDHP) is an inexpensive option that generally doesn t start paying for enrollees healthcare expenses until a high threshold is met (usually a several thousand dollar deductible) but typically covers them after that. Preventive care is covered at 100 percent and is not subject to the annual deductible. There is no coverage for preventive services out of network. Ancillary Products Beyond its core products, PHP also offers a number of ways to customize the health coverage an employer offers. These include additional medical services as well as techniques for reducing healthcare costs. Health Savings Accounts (HSA). A health savings account is an alternative to traditional health insurance; it is a savings product that offers a different way for consumers to pay for their healthcare. HSAs enable employees to pay for current health expenses and save for future qualified medical and retiree health expenses on a tax-free basis. Flexible Spending Accounts (FSA). An FSA is an employer-sponsored benefit that allows the employee to save pretax dollars for medical expenses not usually covered by healthcare insurance. This usually means deductibles, copayments, and coinsurance, but it can also include expenses such as dental and vision charges and over-the-counter drugs. Generally, allowable items are the same as those under the medical tax deduction. The Internal Revenue Service s annual cap for a medical FSA is $5,000; however, employers may set a lower cap on the 02

4 Sparrow Health amount the employee may contribute. Employees contribute a predetermined amount up to the cap, which is taken from their paychecks before taxes are calculated. When an employee has an eligible medical expense, he or she submits a claim to the FSA and is reimbursed up to the amount the employee elected to contribute to the account. Reimbursements from the FSA are not taxed. Prescription Drug Plans (HMO/POS, PPO). PHP also offers several prescription drug plans to choose from. All prescription plans include coverage for mail order a 90-day supply for two retail copays. Essentials Rx Plans. PHP s new Essentials Rx Plans give employers the opportunity to offer a prescription drug package with the qualities employees are looking for, and at a price that fits within the business budget. Carson City Hospital. The health system has dozens of satellite care centers. Sparrow also offers the Michigan Athletic Club, a 276,000-square-foot facility voted one of the country s top health clubs. Sparrow s founding dates back to 1896, when the Women s Hospital Association set out to bring critical medical services to Lansing. One doctor and one nurse worked out of a rented house, while the women of the association did everything they could to support operations, including loaning their own household linens when supplies ran low. In 1910, at a time when the expanding auto industry brought an influx of new families into the area, Edward W. Sparrow one of Lansing s pioneer developers donated land on East Michigan Avenue along with a gift of $100,000 to help build a new hospital. The hospital took in its first patients in Below are some of Sparrow s partners: Mayo Clinic Care Network Mary Free Bed Rehabilitation Hospital Hayes Green Beach Memorial Hospital Michigan State University Sparrow Health Sparrow has grown to become the region s largest health system, and its diverse range of facilities offer residents some of the most advanced medical technology available in the world. Sparrow has two Lansing campuses Sparrow Clinton Memorial Hospital in St. Johns and Sparrow Ionia Hospital in Ionia and an affiliate hospital Center for Innovation Integrated Pediatric Specialty Services Thoracic and Cardiovascular Institute Sparrow Physicians Health Network Mid-Michigan MRI, Inc. Sparrow Michigan Athletic Club 03

5 Position Description T he... major function of the Chief Executive Officer (CEO) is to provide overall leadership and direction for Physicians Health Plan (PHP), ensuring that quality, cost-effective, and compassionate healthcare services are available to plan members. Working in collaboration with the executive team of Sparrow and the Physicians Health Plan board, the CEO develops an overall direction for the Plan through the creation of a strategic vision and plan. The CEO serves in both a management and governance role. He/she fulfills the governance role through his/ her membership on the Board of Directors of Physicians Health Plan. The CEO is responsible for effectively managing the developmental, financial, marketing, and member-related entities within the Plan, and for the recruitment, selection, and development of the executive management team of the Plan. More strategically however, the CEO will help drive the overall integration of the Plan with the business initiatives of the Sparrow Health System. As a provider-owned health plan, significant strategic imperatives and opportunities exist to leverage the providing and financing of healthcare across the entire continuum. The CEO will be instrumental in the development of products and services to serve and expand the current market and to ensure the Plan s success in the ever-changing healthcare landscape. This includes the possible creation and support of partnerships and population health initiatives such as ACOs, Medical Home, MSO activities, and the like. Developing and embracing new models of care being driven across the system is of primary importance. The CEO is the primary liaison with the community for PHP and fulfills this function by serving as a member of the Boards of Directors of appropriate community organizations. He/she is responsible for serving as the leadership linkage for PHP with other local, state, and national managed healthcare organizations. Reporting Relationship The President and Chief Executive Officer, Physicians Health Plan reports to the Senior Vice President, Affiliate Operations. Principal Accountabilities Develops, implements, and manages strategic planning and operating planning processes to position PHP for continued success in response to anticipated changes in the market place. Planning processes are participatory and inclusive of all stakeholders. 04

6 Position Description, continued Maintains clear strategic direction, establishes organizational consensus, obtains results consistent with chosen strategic direction, and creates competitive advantage to ultimately improve the health status of members in the Mid-Michigan region by delivering quality, compassionate, accessible, and cost-effective healthcare. Represents PHP with key stakeholders, including business, community, providers, and government representatives to maintain support and goodwill. Develops and implements a management infrastructure to ensure that all managed care products are aligned with chosen strategic direction and that effective support services are in place. Participates with the governing board and executive team in planning the future direction of the Plan in a manner which is consistent with the organizational mission, community need, and economic solvency. Provides oversight in gathering operational performance data and trends in order to report to board and advise directors regarding current and projected trends, areas of deficiency, and significant activities impacting PHP and in the healthcare field to facilitate policy making. Provides leadership in the coordination of effort between boards of directors and the executive team of the System and the Plan. Assist in identification of market forces or internal strategic objectives that can establish the necessary foundation for population health; review staffing structure, care management teams, and patient engagement tools; and develop an action plan to help prepare for a populationbased delivery model. Experience and Qualifications Master s degree in business, healthcare administration, or equivalent is required. Fifteen years of experience in the managed care field with at least 10 years of progressive experience in healthcare at the manager, director, and executive levels. Leadership style consistent with Sparrow s organizational values of excellence, service, people, responsibility, innovation, and teamwork, and PHP s values of compassion and trust. Advanced interpersonal skills to effectively deal with complex situations with a variety of influential internal and external constituencies. Strong communication skills. Previous P&L experience. Experience in strategic planning. Experience in negotiation skills. As Sparrow Health System evolves into a more clinically integrated enterprise, the CEO will play a key role in system-level initiatives and drive PHP s role in the overall strategy development. 05

7 Lansing, Michigan... T he Chief Executive Officer position will be in the organization s Lansing, Michigan, location. Lansing, Michigan Whether you are traveling for business or pleasure, Lansing, Michigan, is a special place to visit. The range of things Lansing is known for is so broad, it s often hard to clearly label exactly who the city is. Lansing is home to the arts, in every possible form. Its world-class performance venues and art galleries show the community has a taste and appreciation for the finer things. Lansing is also a hard-working industrial town. As the home of some of the most current and high-tech General Motors facilities in the world, it s obvious this community knows how to roll up its sleeves and get to work. Lansing is also Michigan s capital city. When legislators meet in Lansing, they debate and discuss political policies that will shape the future of Michigan for generations to come. The city is also home to Michigan State University, one of the nation s leading educational institutions, full of tomorrow s professionals studying nearly every subject possible, and having a little fun along the way. The Greater Lansing area is home to more than 500,000 people and 35,700 residential units, giving a wide range housing options. A majority of Lansing s housing is just minutes away from major highways but still surrounded by the abundant natural beauty of the area. For more information on Lansing, Michigan, please visit these links: or 06

8 About Furst Group F... urst Group is in its fourth decade of providing leadership solutions for the healthcare industry. Our experience in evaluating talent, structure, and culture helps companies align their organizations to execute their strategic initiatives. We look forward to working with you as a potential candidate for the Chief Executive Officer position for Physicians Health Plan in Lansing, Michigan. For additional information on Furst Group, please visit our Website at furstgroup.com. To learn more about this position, please call (800) or contact: Ginny Gittemeier ggittemeier@furstgroup.com Bob Clarke bclarke@furstgroup.com Illinois Missouri Washington, D.C. Minnesota Arizona California Washington Texas furstgroup.com NOTICE: - community in which the client resides, the client s market, products, and/or services and its environment or culture is provided only 2014, Furst Group. All rights reserved.