Our Story - Our Partners

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1 Chief Administrative Officer North Carolina Provider Owned Plans, Inc. The Company: North Carolina Provider Owned Plans (NCPOP or Plan) is a new health plan initially formed to pursue a managed Medicaid contract with the State of North Carolina as it transitions from feefor-service to a managed care model. The Plan is also positioned to expand its offerings into other product lines and pursue additional business opportunities including employer partnerships, wellness programs and other related offerings. NCPOP was formed through the collaborative efforts of eleven respected North Carolina health systems which hold 75% ownership interest in the Plan through their jointly owned company Provider-Led, Patient-Centered Care, LLC (PLPCC). Owners of NCPOP include: Our Story - Our Partners

2 25% of the Plan is held by Presbyterian Network, Inc., a subsidiary of Presbyterian Healthcare Services (PHS). PHS is a not-for-profit healthcare system, serving New Mexico for over 108 years, which has operated under an integrated model owning hospitals, physician groups and health plans in Albuquerque, New Mexico for 25 years. Our Partnership Model North Carolina Provider Partners Provider-Led, Patient-Centered Care (PLPCC) Health Systems Provider-based clinical and care management Partners in quality, risk adjustment and experience Partners in medical cost management North Carolina Provider Owned Plans Executive leadership and strategy Collaboration and integration with partners Purchaser and provider facing functions Fluent Health (MSO) Powered by Presbyterian Start up support Ongoing core health plan services where efficiency is achieved for NCPOP through existing scale Medicaid revenues for NCPOP are initially projected at approximately $2.0 - $3.5 billion based on inclusion or carve-out of behavioral health services and consideration of expansion populations in North Carolina. The higher revenue range is anticipated at the time behavioral health is integrated 0-4 years after implementation. Revenues will increase as other product lines and service offerings are added.

3 After an initial period of significant development to ensure the successful implementation of services in North Carolina and at Fluent Health success will be determined by not only the performance of the Plan but also the performance of the PLPCC owner health systems and Presbyterian under a highly collaborative and unique model of shared financial performance including: Growth Quality and Performance Outcomes Member Experience and Satisfaction Outcomes Financial Performance Premium, Medical Cost and Utilization Targets The Role: This position serves as the senior administrative officer for NCPOP including leadership for finance, information technology and local administrative operations. The CAO will provide vision and strategic direction to NCPOP s executive team and our Provider-Led, Patient- Centered Care owners as well as represent NCPOP to government, business and physician leaders across North Carolina. NCPOP s unique administrative model is based on a design where Plan executives are responsible for (i) strategic direction and overall performance of the Plan, (ii) leading state, customer and provider facing functions in North Carolina and (iii) providing oversight and direction to a service organization which will provide core technology and certain administrative services to NCPOP. This is a hands-on role which is integrally involved in the day-to-day operations of the business. Initial development activities will include: completion of a detailed business plan based on data provided by the State of North Carolina, contracting of the Plan s provider network, creating strategy and content for the expected response to Request for Proposal issued by North Carolina Department of Health and Human Services in Spring 2018 and working with Fluent Health in establishing financial, IT and administrative structures and processes.

4 Subsequent to contract award, activities will center around oversight of implementation of NCPOP as well as creating shared structures and processes supporting success for the Plan and its health system owners. NCPOP is seeking an experienced leader who can work within a multi-disciplinary leadership team to establish the Plan s brand, partner with providers, and grow membership to a position of prominence in the market against considerable competition by other health plans. The Chief Administrative Officer must bring a blend of strategic and visionary skills combined with strong knowledge of health plan finance and information technology as well as the ability to oversee local administrative functions. Ideally, the individual would be a seasoned executive who has a deep understanding and experience in Medicaid and/or provider-led health plans. Candidates will be diplomatic, collaborative and comfortable leading a health plan with a unique operating model and which is owned by mission-driven organizations in a time of transformational change in the financing and delivery of health care. Summary of Responsibilities: Strategy, Vision, Plan Development and Performance Under the direction of the CEO, the CAO provides vision, strategic direction and oversight for financial and information technology services as a key member of the executive team with primary day-to-day responsibilities for: Start Up: Development and implementation of NCPOP as a start-up health plan including: o Collaborating with other leaders in development of comprehensive RFP strategy and content. o Development of business plan in collaboration with PLPCC owner health systems.

5 o Collaborating with other leaders in the development of an adequate provider network to ensure requirements of RFP are achieved and access for members. o Talent acquisition to build Finance, Medical Economics and Data and Analytics teams. Finance: Overall accountability for all aspects of Finance, Medical Economics and Data and Analytics in NCPOP. Financial management of the organization to include budget analysis and management, financial modeling and reporting, cost benefit analysis, forecasting needs, accounting, treasury operations, investment strategies and audit. Develops risk and valued based reimbursement programs based on aligned incentives, educates provider groups to the programs, oversees the reporting of the programs, and assures proper risk and payments to providers. Prepare materials and present, as necessary, financial information to Board of Directors or other committees. Collaborate with executive team on developing the operating budget. Ensure maintenance of internal controls and compliance with state and federal requirements regarding controls, reporting, risked based capital, etc. Responsible for identifying medical cost trends and, together with Plan and partner clinical leadership, developing medical cost improvement initiatives. Perform financial impact analysis for provider and other contracts and support negotiations. Oversee and validate pricing models, lead rate setting activity and coordinate external and state actuaries. Direct health plan analytical needs and coordinate reporting strategy.

6 Information Technology: Overall accountability for all aspects of IT in NCPOP including procedures, processes, and administration, Oversight of Fluent Health in its provision of IT services including network and hardware support, core operating systems and applications: o Participate in Fluent Health IT strategic planning and work with Fluent Health IT achieve alignment and ensure short and long term needs of NCPOP are met. o Collaborate with Fluent Health to ensure strategic alignment and operational success for NCPOP to meet business needs and ensure high level of customer, provider and employee satisfaction. o Recommend improvements to systems in place to Fluent Health. o Conduct due diligence and collaborate with Fluent Health on the timing and implementation of significant development or technology investments as they relate to NCPOP goals and needs. Ensure appropriate DR (Disaster Recovery) plans are in place both for Fluent Health and NCPOP and that DR is tested on a routine basis. Ensure applications meet business and regulatory requirements. Maintain awareness and understanding of current and emerging technology. Local Administrative Operations: Overall accountability for Human Resources for NCPOP employees including policy, recruiting, training and benefits. Overall accountability for facilities and equipment for NCPOP.

7 General: Interface with contractors, as well as state, federal and other regulatory agencies. Manage, select, evaluate, train, lead and direct staff in support of business efforts; build efforts; build effective team and ensure staff development. Program Development Oversight and Management Collaborating with leaders in the development and implementation of approaches that engage provider partners in strategies required for success in value based reimbursement. Integrates the collaborative functions between NCPOP and Fluent Health where indicated in Finance and IT to maximize efficiencies, ensure appropriate infrastructures and ensure seamless services for Plan members, providers and staff. Business and Relationship Development and Management Broad relationship management and integration efforts with PLPCC owner health systems to achieve Plan strategies. Broad relationship management with State leaders, purchasers, providers and key stakeholders. Represents the organization to inside and outside constituents and customers. Supervised by: President and CEO, North Carolina Provider Owned Plans, Inc. Supervision Exercised: NCPOP Finance, IT, Medical Economics and Data and Analytics, Human Resources

8 NCPOP Organizational Chart: Chief Administrative Officer President and CEO Chief Administrative Officer Finance IT Medical Economics Data and Analytics Local Administrative Operations 4 Experience/Education: Bachelor of Science Degree in Accounting or Finance; advanced degree or equivalent preferred (CPA/MBA) 5 years in executive level Finance position within managed care organization; experience in Managed Medicaid experience and provider-led plans preferred. Strong knowledge of health plan/managed care information systems and applications as well as data transfer including eligibility, encounters and reporting.

9 Skills: Strategic thinker with proven ability to lead change organizationally. Flexible management style and the ability to function as part of a high-level team where it will be necessary to produce results and provide highly responsive services in a startup environment. Maturity, stature and communication skills to assume a key leadership role in a progressive organization that relies on partnership and collaborative efforts to ensure success. Understanding of various health system cultures and mindset of provider healthcare systems. Success in business development environments. Ability to build partnerships and influence. Collaborative yet strong negotiation skills. Ability to manage multiple parties with divergent needs to common goals.