Clinical Transformation Director

Overview

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. The incumbent is responsible for ensuring collaborative work with the value-based reimbursement team, provider relations, senior markets, analytics, actuary, and key internal / external stakeholders. The role has ownership and directional leadership of three primary workstreams : leading the execution of the Population Health Performance strategy roadmap, supporting physician executives to identify ownership and direction of enhanced clinical integration, and directing and building processes to drive success for internal initiatives.

Responsibilities

Strategic Roadmap Implementation : Execute 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 with the ED&A team. Support interpretation of clinical and cost outcomes, and report to identify trends and opportunities in cooperation with the ED&A team. Engage with care analytics and medical economics teams as a subject matter expert in the design and build of partnership scorecards and population health assessments. Lead anchor operations committees 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 activity of other clinical resources deployed to support the anchor (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 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 report 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 value is realized 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 of the SVP of Clinical Transformation, working with stakeholders across the Enterprise. Ensure the design delivers value and improves patient and clinician experience as it relates to interfacing with Highmark Health. Consider provider and Highmark Health priorities in strategic roadmaps. Identify and support development of person-centered comprehensive care programs that support the quadruple aim and complement the overall value strategy. 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, including at least 2 years developing business cases and operationalizing clinical programs

Preferred

Skills

Education

Required

Licenses or Certifications

Required

Travel

0% - 25%

Physical, Mental Demands and Working Conditions

Position Type

Office- or Remote-based

Occasionally travel from the office to various work sites or site-to-site

Rarely works primarily out of the office selling products / services (sales employees)

Never physical work site required

Lifting : up to 10 pounds – Occasionally

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 and must protect it at all times. All employees must comply with HIPAA and the company’s privacy and information security policies.

It is every employee’s responsibility to comply with the company’s Code of Business Conduct and applicable laws, rules, and regulations as well as company policies and training requirements.

Compensation

Pay Range Minimum : $92,300.00

Pay Range Maximum : $172,500.00

Base pay is determined by a variety of factors including qualifications, experience, expected contributions, internal peer equity, market, and business considerations. The salary range does not reflect geographic differentials Highmark may apply for certain locations.

Highmark Health and its affiliates prohibit discrimination based on protected veteran status or disability and prohibit discrimination based on any category protected by law.

We strive to make this site accessible. For accessibility assistance or accommodation requests, contact HR Services Online at HRServices@highmarkhealth.org

Req ID : J268693

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