Job ID: J131755
Company: Highmark Inc
Location: Pittsburgh, PA, United States
Full/Part Time: Full time
Job Type: Regular
Posted at: Sep 12, 2018
This job directs and manages the enterprise wide Medicare/Medicaid (Stars and/or ACA Quality Performance) programs, which provides oversight and guidance for the enterprise portfolio of programs and projects. Works collaboratively with multiple stakeholders, vendors and various cross-functional teams, locations and departments to improve Stars and/or Quality Rating outcomes for Medicare Advantage, Federal Employee Program and Exchange products in three states. Leads enterprise efforts to maximize Mobile Clinic partnership with AHN and other physician partners. Leads efforts to perform analysis of enterprise-wide practices to identify opportunities for improvement. Designs, implements and executes strategies and works with cross-functional clinical, pharmaceutical, operational, IT and Performance Management improvement teams to ensure overall goals of the Organization are met and to optimize outcomes. Provides budgetary oversight for the successful execution of strategies direct and indirect reports that ensures delivery of $200+M in annual revenue. Collaborates with the company's Medicare, FEP, and/or ACA's Quality Program Management processes, procedures and best practices and chairs the oversight governance committee to ensure all supporting areas are utilizing standard processes, tools and data standards for managing the interventions. The incumbent provides regular status, program health and escalating cross-portfolio dependencies, project risks and items for management attention to the executive leadership team.
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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