Job Details

Company :

Highmark Health

Job Description :

JOB SUMMARY

This role will support the leadership team for Clinical Transformation and executive physicians in leading the day-to-day operational model of the clinical transformation teams as it relates to developing and executing the Anchor partner clinical roadmaps. This job has ownership and directional leadership of three primary Workstreams: leadership over the execution of the Population Health Performance strategy roadmap, support physician executives to identify ownership, development, and direction of enhanced clinical integration, and directing, supporting, building processes to drive success for internal initiatives. The incumbent is responsible for ensuring collaborative work with the other members of the value-based reimbursement team, provider relations, senior markets, analytics, actuary, and key internal/external stakeholders.

ESSENTIAL RESPONSIBILITIES

• Strategic Roadmap Implementation: Execute on the implementation of the strategic roadmap for clinical transformation. Lead clinical transformation committees with internal and external stakeholders, including population assessment analysis, strategic ideation, and joint roadmap implementation work groups. Coordinate with internal and external subject matter experts to inform business case assumptions for identifying clinical initiatives to be included in the roadmap.

• Project Management & Coordination: Coordinate and prepare executive presentation updates, bingo card maintenance, joint initiative tracking, and reporting in collaboration with the ED&A team. Support interpretation of clinical and cost outcomes, reporting to identify trends and opportunities in cooperation with the ED&A team. Engage with care analytics and med econ teams as a subject matter expert in the design and build of partnership scorecards and population health assessments. Lead anchor operations committees in conjunction with the VP of Markets from Highmark and anchor executive leaders identified by health provider partners. Maintain day-to-day activation with clinical leaders of anchor partners to ensure solutions are embedded into practice workflows at scale and resolve problems. Strategize with internal stakeholders on the implementation of large-scale programs. Manage, through collaboration, the day-to-day team activity of other clinical resources deployed to support the anchor, including MAQCs and pharmacists, in collaboration with the partnership director who manages non-clinical workforce activity.

• Relationship Management & Communication: Ensure the team has established key contacts in all critical areas of important provider entities. Ensure the right resources and execution plans are in place to deliver, surface, and help resolve concerns and issues. Communicate provider partner feedback on efficiency and quality programs and communicate the status of efforts to senior leadership. Support internal and external facing cultural experience for Highmark and the anchor partner clinicians.

• Performance & Reporting: Ensure execution is effective, timely, consistent, and coordinated. Track and ensure CTV value is realized, captured, and contextualized with respect to implications on Enterprise strategy internally and externally. Provide feedback to leadership on the operating model.

• Initiative Leadership: Design and drive various clinical initiatives under the leadership and guidance of the SVP of Clinical Transformation, working with stakeholders across the Enterprise. Ensure the design will deliver the C2V and improve patient and clinician experience as it relates to interfacing with Highmark Health. Ensure priorities of providers and Highmark Health are considered in any strategic roadmap. Identify/support the development person-centered comprehensive care programs that support the quadruple-aim and complement the overall value strategy for our providers. Adhere to the Organization's design operations management methods, life cycle methodologies, and audit requirements. Support and contribute to the improvement of design operations management methods. (Agile Product Owner).

• Other duties as assigned or requested.

EXPERIENCE

Required

• 7 years of experience in a clinical or healthcare role to include at least 2 years developing business cases and operationalizing clinical programs

Preferred

• Experience operationalizing clinical programs in a large multi-hospital health system

• Experience working in provider partnerships

• Experience with data analytics and medical economics

SKILLS

• Organizational skills and detail orientation

• Strong communication and collaboration skills

• Ability to organize work and collaborate within a highly-matrixed organization

EDUCATION

Required

• Bachelor's degree or relevant experience and/or education as determined by the company in lieu of bachelor's degree.

LICENSES or CERTIFICATIONS

Required

• None

Preferred

• None

Language (Other than English):

None

Travel Requirement:

0% - 25%

PHYSICAL, MENTAL DEMANDS and WORKING CONDITIONS

Position Type

Office- or Remote-based

Teaches / trains others

Occasionally

Travel from the office to various work sites or from site-to-site

Rarely

Works primarily out-of-the office selling products/services (sales employees)

Never

Physical work site required

No

Lifting: up to 10 pounds

Constantly

Lifting: 10 to 25 pounds

Occasionally

Lifting: 25 to 50 pounds

Rarely

Disclaimer:The job description has been designed to indicate the general nature and essential duties and responsibilities of work performed by employees within this job title. It may not contain a comprehensive inventory of all duties, responsibilities, and qualifications required of employees to do this job.

Compliance Requirement

This job adheres to the ethical and legal standards and behavioral expectations as set forth in the code of business conduct and company policies.

As a component of job responsibilities, employees may have access to covered information, cardholder data, or other confidential customer information that must be protected at all times. In connection with this, all employees must comply with both the Health Insurance Portability Accountability Act of 1996 (HIPAA) as described in the Notice of Privacy Practices and Privacy Policies and Procedures as well as all data security guidelines established within the Company's Handbook of Privacy Policies and Practices and Information Security Policy.

Furthermore, it is every employee's responsibility to comply with the company's Code of Business Conduct. This includes but is not limited to adherence to applicable federal and state laws, rules, and regulations as well as company policies and training requirements.

Pay Range Minimum:

$92,300.00

Pay Range Maximum:

$172,500.00

Base pay is determined by a variety of factors including a candidate's qualifications, experience, and expected contributions, as well as internal peer equity, market, and business considerations. The displayed salary range does not reflect any geographic differential Highmark may apply for certain locations based upon comparative markets.

Highmark Health and its affiliates prohibit discrimination against qualified individuals based on their status as protected veterans or individuals with disabilities and prohibit discrimination against all individuals based on any category protected by applicable federal, state, or local law.

We endeavor to make this site accessible to any and all users. If you would like to contact us regarding the accessibility of our website or need assistance completing the application process, please contact the email below.

For accommodation requests, please contact HR Services Online at ...@highmarkhealth.org

California Consumer Privacy Act Employees, Contractors, and Applicants Notice

Req ID: J268693

J-18808-Ljbffr