Provider Integration Consultant

Company :

Job Description :

JOB SUMMARY

This job leads execution of the department's strategies, goals and objectives to continually lead, monitor, and manage large scale projects and initiatives with a focus on supporting provider integration. The incumbent will also be charged with the development, coordination and management of matrixed projects to improve the health of our members. Accountable for assuring the analysis and outcomes reporting for all assigned programs. The role will collaborate with matrixed partners across the enterprise to develop short and long-range business plans to support the achievement of objectives of all assigned projects.

If you are within 50 miles of an office this is a hybrid based role in Pittsburgh, PA. 3 days a week onsite. T, W, Th. If outside of the 50 miles this role will be remote.

ESSENTIAL RESPONSIBILITIES

• Serve as a Subject Matter Expert to market executives, senior leadership, and matrixed partners to provide project management consultation for provider initiatives, strategy development, and product solutions.
• Manage the relationship with internal and external stakeholders with a provider and market focus.
• Work independently to coordinate, align, and implement provider integration strategies to improve member outcomes and reduce medical costs for all lines of business in collaboration with market and physician executives.
• Develop and implement tactical plans to achieve Highmark strategic objectives.
• Responsible for reporting out on activities to implement Living Health Partnership strategies.
• Coordinate internal and external resources for execution of program, product and/or solution implementation.
• Develop scope and objectives, involve all relevant stakeholders and drive initiatives to completion.
• Ensure all work is delivered on-time and within scope inclusive of risk management using mitigation strategies and escalation as appropriate.
• Other duties as assigned or requested.

EDUCATION

Required

• Bachelor's Degree in Business Administration/Management, Finance, Health Administration, Industrial Engineering, or a Health Care Related field

Substitutions

• 6 years of related and progressive experience in lieu of Bachelor's degree

Preferred

• Master's Degree in Business Administration/Management

EXPERIENCE



Required

• 7 years in Project Management in the healthcare industry OR 3 years in Program Management in the healthcare industry

Preferred

• None

LICENSES AND CERTIFICATIONS

Required

• None

Preferred

• Project Management Professional (PMP)

SKILLS

• Budget Management
• Building and Leading Teams
• Leading Change
• Program Evaluation
• Program Management
• Written & Oral Presentation Skills
• Innovation
• Research
• Highly Organized

Language (Other than English)

None

Travel Required

0% - 25%

PHYSICAL, MENTAL DEMANDS and WORKING CONDITIONS

Position Type

Office-Based

Teaches / trains others regularly

Frequently

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

Occasionally

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

Never

Physical work site required

Yes

Lifting: up to 10 pounds

Frequently

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 position 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.

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.

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