Director, Clinically Integrated Network Operations

Position Summary / Career Interest:

The Director of CIN Operations is responsible for overseeing the strategic, operational, and financial performance of the organization's Clinically Integrated Network(s) (CIN) and other affiliated network organizations. This role ensures effective care coordination, population health management, regulatory compliance, and achievement of quality and cost targets under value-based care payment and care models. Must have strong background in contracting, and managing, complex value-based reimbursement models across multiple lines of business (LOB) (e.g. Medicare, Medicaid, Medicare Advantage, Commercial, etc.) and through multi-party (hospitals, physicians, allied health providers, etc) entities.


Responsibilities and Essential Job Functions

• Strategic Leadership
• Develop and execute CIN operational strategies aligned with organizational goals
• Partner with executive leadership to drive value-based care initiatives
• Coordinate all board and governance related activities of the CINDR
• Lead growth and optimization of CIN programs and payer contracts
• Operations Management
• Oversee daily CIN operations, including care coordination, network performance, and provider engagement
• Implement workflows to improve efficiency and patient outcomes
• Monitor and improve operational KPIs
• Population Health & Care Management
• Direct population health strategies, including risk stratification and care management programs
• Ensure effective transitions of care and chronic disease management initiatives
• Collaborate with clinical leaders to improve quality outcomes
• Financial Performance
• Manage CIN budgets, shared savings/loss models, and cost containment strategies
• Analyze utilization, cost trends, and financial performance
• Identify opportunities for savings while maintaining quality care
• Quality & Compliance
• Ensure compliance with CMS and other regulatory requirements
• Monitor quality metrics (e.g., HEDIS, CMS ACO measures)
• Lead quality improvement initiatives and reporting
• Data & Analytics
• Utilize data analytics to drive decision-making and performance improvement
• Oversee reporting dashboards and performance tracking
• Translate data insights into actionable operational strategies
• Provider & Stakeholder Engagement
• Build strong relationships with physicians, hospitals, and network providers
• Support provider education on value-based care and CIN performance
• Collaborate with payers and external partners
• Must be able to perform the professional, clinical and or technical competencies of the assigned unit or department.
• These statements are intended to describe the essential functions of the job and are not intended to be an exhaustive list of all responsibilities. Skills and duties may vary dependent upon your department or unit. Other duties may be assigned as required.

Required Education and Experience

• Bachelors Degree in Healthcare Administration, Business, Nursing, or related field required
• 7 or more years of healthcare experience

Preferred Education and Experience

• Master's Degree MHA, MBA, MPH, or similar
• 3 or more years in CIN, population health, or value-based care leadership
• Experience with CMS ACO programs (e.g., MSSP)

Knowledge Requirements

• Strong knowledge of value-based care models and healthcare reimbursement
• Experience with healthcare analytics and performance metrics
• Excellent leadership, communication, and stakeholder management skills
• Financial acumen and strategic planning expertise
• Familiarity with EHR systems and population health platforms

We are an equal employment opportunity employer without regard to a person’s race, color, religion, sex (including pregnancy, gender identity and sexual orientation), national origin, ancestry, age (40 or older), disability, veteran status or genetic information.