Job ID: J129129
Company: Highmark Inc
Location: Pittsburgh, PA, United States
Full/Part Time: Full time
Job Type: Regular
Posted at: Aug 10, 2018
This job builds out and advances Consulting Services within HM Health Solutions.
The incumbent is accountable for the initial implementations of each client taking them through Discovery, Refinement, Transformation and Stabilization phase. These implementations span Commercial, ACA/Individual, Medicare and Medicaid lines of business.
The incumbent drives partnerships with other areas across HMHS to understand the status of capabilities in development, capability life cycle management and drive a dialog to understand how to leverage new capabilities for additional revenue and/or value add. The leader ensures the Capabilities are mapped to resource expenditures and risk profile of delivery. Drives the reporting of progress delivering capabilities to the market, ensuring integration risks are reported and risk and issue management functions are performed in a timely and complete manner driving to consistent delivery.
The incumbent executes the annual planning processes across all partners and facilitates regular progress reviews with Executive Customer leadership. Ensures the status of programs, projects and portfolios of capabilities are accurately monitored and reported to executive management. Achieves greater efficiency and reduced instance of project failures, and more value-creation opportunities for clients to lead to higher client satisfaction.
The incumbent manages support requests back into Highmark Inc. and the Diversified businesses. This support includes Claims, Enrollment, Provider, Benefits, Clinical and other services in support of BPO arrangements and/or direct product line services for Dental and Vision for the ASP customers.
The incumbent provides senior leadership direction and day-to-day oversight for the following divisions: Planning & Delivery Management; Practice Leadership (five areas); Change Management; Solutioning; Client Delivery (Three primary customers with more than 9 million members).
Planning & Delivery Management
•Develop and maintain the HMHS Strategic Roadmap and Capabilities.
•Oversee the planning and management of inter-dependencies, risks, critical issues, annual three year planning cycles across all the ASP customers creating the centralized view of customer needs along with product delivery.
•Drive the linkage of Strategy with Resource Investment and Capability delivery mechanisms. Develop and build a Program & Project management competency center for Health Services, Finance and Corporate organizations.
•Development of best practices, estimating protocols, project management review and QC processes.
•Drive the development of thought leaders and resources that can reflect the brand, value proposition and delivery excellence expected from HMHS Consulting.
•Build out consulting and management services across broad multi-function office verticals including Front Office, Provider, Clinical, Government Programs, Back Office, Analytics and Enterprise.
•Execute approaches to facilitate and drive adoption of Highmark’s capabilities by ASP clients and its markets, serving as a trusted advisor to HMHS customers, driving attainment of value through collaborative and effective advisory management services, serving in or architecting co-management arrangements with customers, and providing innovative adoption-oriented (internal functions and market-facing) approaches with customers.
•Develop, design and implement complex and transformation changes at client site.
•Build methods and a consulting workforce that is viewed as top tier in the industry to develop and implement solutions for a diverse client base.
•Leads involvement in preparing other plan affiliation business case and proposal (written & verbal) to the pending RFP.
•Provides HMHS clients with a robust change management, operational readiness and value realization process throughout the life-cycle of project and portfolio to ensure the client realizes the benefits of the planned changes from large $100+ million dollar investments.. Oversee the strategy, development and execution of processes to guide senior leaders in each ASP Client through the process of executing a large portfolio of transformational change.
•Oversee the functional Blueprinting, Solution Consulting (Integration Architecture and Business Architecture), Business Re-engineering and Estimating processes for HMHS. Ensure cost-effective solution development with large ASP customers including Highmark, Highmark Health Enterprise, Independence BC, Minnesota BCBS and upcoming ASP Customers from Discovery through Delivery.
•Oversee the establishment of the strategic business and functional capabilities (existing and future) of the current and future capabilities supporting the ASP customers.
•Oversee the business review and planning efforts to review the viability of a capability across the ASP and in the product plan at any point in the life-cycle and monitors the inter-dependencies between solutions.
•Oversees client relationship activities for 10-year contractual relationships with ASP partners.
•Lead the strengthening of the account relationship, including execution of strategy and tactical activities required to support the 10-year business case as well as the future needs of ASP partners while also protecting Highmark’s interests.
•20 years of progressive management experience which includes:
•Deep, proven expertise in multi-functional management, strategy development and/or integrated tactical implementation for complex, large initiatives.
•Developing business cases and/or comprehensive presentations to executive- and board-level leader
•Experience managing large/mega-scale technology and process-related projects, and driving these projects to on-time, on-budget implementation, while achieving stated benefits
•Experience in budget administration, financial forecasting, cost allocation techniques, activity-based accounting, budget analysis and reporting
•Demonstrated experience in major process improvement, innovation and Strategic Planning
•Demonstrated experience leading PMO and/or RDO activities
•High standard of professional conduct and excellent business writing skills
•Ability to maintain confidential information
•General knowledge of human resources
•Good knowledge of financing and/or budgeting
•High knowledge of service levels and service requirements
•Demonstrated experience in administrative cost reduction approaches
•Experience in team interactions and team facilitating
•Ability to quickly identify and provide recommendations on issues.
•Strong communication both written and oral
•Excellent team building and professional development skills
•Solid negotiation and influencing skills across Sales, technical and operations partners
•Innovation program experience
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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