Clinical Strategy Lead

Company :

Highmark Health

Job Description :

JOB SUMMARY

This job functions as a member of an inter-disciplinary team that supports the Enterprise Clinical Operations with a range of strategic activities essential to realizing the potential of and growing Population Health Solutions. Provides clinical expertise, strategic thinking, and leadership support that enables project teams and partners to personalize, bundle, and deploy solutions for our customers. Leverages a new approach grounded in advanced analytics, human centered design, and a true clinical viewpoint to understand a customer's physical, mental and social health needs, challenges, and preferences. Leads by influence working with clinical, analytic, and business teams to understand the pain points associated with customer journeys and define the correct solutions. Makes formal recommendations regarding best-in-class solutions that should be adopted. In addition to engaging with clinicians across the enterprise ecosystem to adopt and scale these solutions, the incumbent will provide clinical expertise across all other functions of the Enterprise Clinical Operations, including Quality, Safety, Value, Informatics, and Research/Innovation. Leverages ongoing collaboration and coordination of other clinical resources, analytic, technical, strategic, and business teams to create requirements to achieve these solution designs and scaling through Population Health partnerships.

ESSENTIAL RESPONSIBILITIES

• Work with business/ market owners to identify key business issues, apply right analytical framework, develop solution and recommendations, represent findings to stakeholders and own the outcome.

• Leverages clinical knowledge to collaborate with stakeholders to define, plan, and design the appropriate end-to-end cross-channel experiences and solutions from a customer and clinician point of view to achieve customer engagement, clinician engagement, health outcomes, and affordability targets and in support of scaling curated health model solutions.

• Accountable for solution outcomes (ROI, KPIs) and collaborates with other clinical partners and/or vendors for solution prototyping and scaling.

• Evaluates new software or technology capabilities, assesses vendor solutions, creates and supports ongoing partnerships with third parties such as clinical vendors.

• Serve as the clinical liaison between Highmark Health and provider partners related to all clinical transformation efforts.

• Serve as clinical subject matter expert to strategic operations staff and stakeholders on membership, growth and operational strategy issues.

• Actively participate in major strategy projects with the support of internal or external strategy consulting resources.

• Other duties as assigned or requested.

EDUCATION

Required

• Bachelor's Degree in Clinical Field of Specialty

Substitutions

• None

Preferred

• Master's Degree in Clinical Field of Specialty

• Doctorate Degree in Clinical Field of Specialty

EXPERIENCE

Required

• 7 years of related, progressive clinical experience in the area of specialization

Preferred

• Experience with virtual health delivery and operations

• Experience with working in a highly matrixed clinical structure

LICENSES or CERTIFICATIONS

Required

• Must hold a current licensure in clinical field of specialty

• Must hold a current board certification in clinical field of specialty

Preferred

• None

SKILLS

• Highly motivated with exceptional organizational skills, including the ability to effectively and competently handle multiple responsibilities simultaneously and the flexibility and ability to quickly adapt to changes in work objectives, promotions, and available technology.

• Independently and in a team, be able to identify the root issues and formulate potential solutions and/or goal-oriented action plans in a professional environment.

• Accurately use logic and reasoning in identifying alternate solutions, conclusions or approaches to problems. Potential solutions should be synthesized into presentation, timetable to resolution and appropriate follow up with measurable outcomes.

• Successfully partners through collaboration and sense of urgency regarding process implementation and improvement/optimization.

• Leads with a customer and clinician-centric lens and advocates for a combined customer and clinician view in all interactions.

• Leadership skills required to facilitate and see through change management across all departments and levels of staff.

Language (Other than English):

None

Travel Requirement:

0% - 25%

PHYSICAL, MENTAL DEMANDS and WORKING CONDITIONS

Position Type

Office-based

Teaches / trains others regularly

Occasionally

Travel regularly 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

Yes

Lifting: up to 10 pounds

Constantly

Lifting: 10 to 25 pounds

Occasionally

Lifting: 25 to 50 pounds

Never

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:

$78,900.00

Pay Range Maximum:

$147,500.00

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 [email protected]

California Consumer Privacy Act Employees, Contractors, and Applicants Notice

Req ID: J271369