Job ID: J114147
Company: Highmark Inc
Location: Pittsburgh, PA, United States
Full/Part Time: Full time
Job Type: Regular
Posted at: Jan 23, 2018
This job supports the Organization's Advanced Value Based Reimbursement Programs Team. The incumbent works closely with management and other stakeholders to develop, coordinate, and manage complex and advanced analysis accompanying existing and new reimbursement models, as well as provides analysis in the development and support of VBR projects and information required to make effective business decisions, and recommend innovative approaches to VBR models and programming. Serves as a liaison and consultant among numerous internal customers, including but not limited to VBR team members, operations, actuary, and advanced analytics and reporting. The incumbent serves as the key link between the design and analytical work in support of VBR initiatives, each related business segment, and functional area partners’ work, with a focus on: The creation of a comprehensive suite of reimbursement models that align with enterprise goals and strategic objectives across multiple areas within the enterprise and at AHN;
Infrastructure and process development to link medical economic related analytics (trend reporting, medical cost, conditions, etc.) with business partner actions, including progress and impact; Function as point person for all business segment medical economic analytics. Manages the organizational matrix – specifically business partners and their respective support functions who have accountability to implement initiatives in the portfolio. There will also be significant emphasis placed on frequent and meaningful interactions with business segment and functional department executive/senior leadership to ensure that new reimbursement initiatives and existing program improvements are identified and executed in a timely manner. This will require engagement with Health Plan Management and Executives(SVPs, VPs, Directors, etc.) in formal and informal situations, and strong demonstration of analytical, communicative, and influencing skills.
LICENSES AND CERTIFICATIONS
Language Requirement (other than English)
0% - 25%
PHYSICAL, MENTAL DEMANDS and WORKING CONDITIONS
Teaches / trains others regularly
Travel regularly from the office to various work sites or from site-to-site
Works primarily out-of-the office selling products/services (sales employees)
Physical work site required
Lifting: up to 10 pounds
Does Not Apply
Lifting: 10 to 25 pounds
Does Not Apply
Lifting: 25 to 50 pounds
Does Not Apply
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.
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 their race, color, religion, sex, national origin, sexual orientation/gender identity or any other category protected by applicable federal, state or local law. Highmark Health and its affiliates take affirmative action to employ and advance in employment individuals without regard to race, color, religion, sex, national origin, sexual orientation/gender identity, protected veteran status or disability.
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