Senior Palliative Care Program Manager

Job ID: J118790
Company: HM Home and Community Svcs LLC
Location: Pittsburgh, PA, United States
Full/Part Time: Full time
Job Type: Regular
Posted at:

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Description

JOB SUMMARY

This job coordinates with the Health Plan to ensure home care service's (HCS’s) clinical pathways and protocols are in compliance with other plans and applicable regulations. This job will also focus on developing the guidelines required to measure evidence based outcomes, and to drive sound clinical practice guidelines and recommendations that align to the needs of the payer organization.

ESSENTIAL RESPONSIBILITIES

  • Drive Strategic Initiatives: Coordinate with the Health Plan to ensure clinical pathways/protocols are in compliance and alignment with HCS and customer initiatives.
  • Drive Strategic Initiatives: Develop the strategy for identifying the specific clinical programs that will coordinate with customer health programs as needed.  Develop the strategy for determining which patients are in need of clinical support, how those patients will be targeted accordingly, and what treatment approach is most appropriate.
  • Drive Strategic Initiatives: Identify where patients are geographically, formalize the process for identifying them accordingly, and understand/articulate the best-fit options for providing HCS solutions and pathways to care.
  • Drive Strategic Initiatives: Work closely with the the network management function to optimize how the best clinical home health practices can be accounted for and aligned to key contracting initiatives and development to help improve clinical outcomes.  Articulate the benefits of clinical adoption and advise on best practices and alignment to HCS services.
  • Drive Strategic Initiatives: Analyze and interpret data to drive clinical adoption and client satisfaction.
  • Customer Management: Develop and socialize strategy for engaging key partners in the community that can support the model from a clinical standpoint by bringing a clinical background to key customer initiatives to ensure the appropriate perspective regarding care pathways is represented.
  • Customer Management: Interface with customer executives (COO, CMO, etc.) to help them understand and support the model from a clinical standpoint and promote HCS services through demonstrations, evaluations, and/or site visits (as needed).
  • Customer Management: Develop a strategy to determine and drive ongoing client satisfaction, retention and testimonials that will resonate with the target customer.  Capitalize on relationship opportunities to ensure the model and applicable services are being represented in the market.
  • Customer Management: Analyze region for revenue opportunities and coordinate with leadership to ensure representation in business and strategic planning.
  • Other duties as assigned or requested.

REQUIRED EDUCATION

  • Bachelor's Degree- Nursing, Medicine, Science or related discipline

Substitutions

  • None

PREFERRED EDUCATION

  • Nursing

EXPERIENCE

Preferred:

  • 5 years' experience in a clinical environment
  • 2 years' experience as a clinical leader
  • 4 years' experience leading/managing teams
  • Experience facilitating organizational change and strategic clinical alignment to business functions goals/values

KNOWLEDGE, SKILLS & ABILITIES

  • Knowledge of medical institution hierarchy

PREFERRED LICENSURE

  • Nursing

TRAVEL REQUIREMENT

25% - 50%
 

LANGUAGE REQUIREMENT

None

PHYSICAL, MENTAL DEMANDS AND WORKING CONDITIONS
 

Position Type:

Office-Based

Office-Based Positions

An employee in this position works in an office environment.  The position frequently requires the employee to communicate effectively with others both inside and outside the workplace (e.g., in person, via telephone, via email).  The employee must be able to understand, interpret and analyze data, solve problems, concentrate, and research, use available technological resources and systems (e.g., computers and computer programs), multi-task, prioritize, and meet multiple deadlines to complete essential tasks.  The employee generally works in a fast-paced and frequently stressful environment, must attend work on a regular and reliable basis as well as adhere to all workplace policies, and may be called upon to work outside regular business hours.

Teaches/Trains others regularly

Frequently

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.
EEO is The Law
Equal Opportunity Employer Minorities/Women/ProtectedVeterans/Disabled/Sexual Orientation/Gender Identity (http://www1.eeoc.gov/employers/upload/eeoc_self_print_poster.pdf)
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 number below.
For accommodation requests, please call HR Services at 844-242-HR4U or visit HR Services Online at HRServices@highmarkhealth.org

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