The County of Santa Clara
California

Personnel Recommendation
90211

Approve job specification and amend classification plan to add classification of Valley Health Plan - Medical Director.

Information

Department:Employee Services AgencySponsors:
Category:Personnel

Body

FISCAL IMPLICATIONS

There will be no impact to the General Fund as a result of this action.  The FY 2017-18 cost is approximately $103,957 and will be absorbed in the Valley Health Plan’s existing budget appropriation in Fund 0380. The annualized cost is approximately $427,026 and will be included in the County Executive’s FY 2018-19 Recommended Budget.

CONTRACT HISTORY

Not applicable.

REASONS FOR RECOMMENDATION

Approval of the recommended action allows Valley Health Plan (VHP) to put in place the organizational structure necessary to advance comprehensive quality assurance and improvement standards adequate to identify, evaluate and remedy problems relating to access, continuity and the quality of health care services. The recommended action also facilitates Valley Health Plan’s ability to develop physician compliance with clinical pathways and protocols, stay abreast of regulatory and accreditation standards, and implications of health care laws and delivery system trends.

CHILD IMPACT

The recommended action will have a positive impact on children and youth.  Having the necessary leadership in place will allow VHP to ensure the Plan is being responsive to the needs of children and youth.

SENIOR IMPACT

The recommended action will have a positive impact on seniors.  Having the necessary leadership in place will allow VHP to ensure the Plan is being responsive to the needs of seniors.

SUSTAINABILITY IMPLICATIONS

The recommended action will have no/neutral sustainability implications.

BACKGROUND

Valley Health Plan is a County-operated managed care organization that provides and administers coverage for almost 160,000 commercial and Medi-Cal lives, representing over $450 million in annualized medical reimbursement expenses. 

In October 2015, VHP created the role of Chief Medical Officer (CMO) to provide greater efficiency and address the changing demands within VHP.  Since then, VHP has experienced rapid growth in size and complexity.  For instance, in December 2017, over 12,000 members were enrolled in VHP through Covered California alone.  There is an increasing need to meet regulatory requirements to maintain a quality network and to implement quality-based performance incentives for the provider network as practiced by other health plans.  The addition of the VHP Medical Director will allow for increased continuity and efficiency, and provide strategic, clinical leadership and medical oversight for VHP’s medical management and business lines that will improve the quality of service and overall health of the membership. 

Realizing the scope of this critical position will increase significantly over time and the need to adapt with overall changes with the health field, it is necessary to create a position at the level of Medical Director.

Therefore, in order to recruit individuals who will be successful in moving forward with the priority of providing the highest level of care, it is necessary to have the appropriate classification that is reflective of the duties needed and those which will be assumed. The salary for the new classification of VHP Medical Director is consistent with the goal of ensuring a competitive package for recruitment and retention of individuals who possess considerable experience and whose background matches the needs of this critical position.

CONSEQUENCES OF NEGATIVE ACTION

The recommended actions related to establishing this new classification would not be implemented and the level of medical leadership needed to implement the current goals and objectives within Valley Health Plan will not occur.

STEPS FOLLOWING APPROVAL

The Clerk of the Board of Supervisors is requested to send MinuteTraq notification of completed processing to Patricia Carrillo, ESA Administration and Staci Bjerk, ESA Human Resources.

Meeting History

Mar 20, 2018 9:30 AM Video Board of Supervisors Regular Meeting
RESULT:APPROVED [UNANIMOUS]
MOVER:Ken Yeager, Supervisor
SECONDER:Mike Wasserman, Supervisor
AYES:Mike Wasserman, Cindy Chavez, Dave Cortese, Ken Yeager, S. Joseph Simitian