VP, Practice Leader - Clinical

Job ID: J107877
Company: HM Health Solutions Inc.
Location: Pittsburgh, PA, United States
Full/Part Time: Full time
Job Type: Regular
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Description

General Overview:

The Practice Leader - Clinicalt Practice, will focus on service delivery and business management advisory for Highmark's inorganic growth of the health business through processing arrangements established with other health plan customers (HPC). The areas covered is defined as those people, processes, and technology solutions focused on care, disease and utilization management along with health and wellness as it relates to both the payor and provider systems in an integrated and non-integrated delivery setting. The Practice Leader will work with functional management to position Highmark-supplied capabilities internally and with ASP & BPO customers along with external market customers (consumers, groups and/ or providers). Working within the professional services and solution delivery organizations at Highmark, the Practice Leader will manage the development and execution of consulting and management services offered to Highmark's health plan customers and prospective customers, and are organized and accountable across broad multi-function office verticals.

 Primary responsibilities include executing approaches that facilitate and drive adoption of Highmark's capabilities by the HPC and its markets, serving as a trusted advisor to the HPC's management team and related functions, driving attainment of value by the HPC through collaborative and effective advisory management services, serving in or architecting co-management arrangements with the HPC, and providing innovative adoption-oriented (internal functions and market-facing) approaches with the HPC. An additional critical role will be to serve as a visible and demanding advocate for the HPC in Highmark's strategic planning and related governance processes, IT delivery, and the overall service/vendor delivery model. In addition, the leader will have direct involvement in preparing other plan affiliation business cases and proposals (written & verbal) to the pending RFP.

The Practice Leader's role also is a significant contributor and leader of the platform planning processes to make sure market needs are exceeded/met and that Highmark's platforms are viewed favorably in the marketplace and with our customer base. This leader is part of an overall practice leadership spanning Front Office, Middle Office, Provider and Back Office. This group is accountable for the capabilities of the overall platform Highmark uses and takes to market as part of the ASP/BPO service offerings marketed by Highmark Health Solutions.

In addition, the Practice Leader has direct engagement in Highmark Health Solutions' business development efforts to cultivate new partnership opportunities with other prospective HPCs by representing Highmark in executive level presentations, business case development, evaluating other plans assets and business value to Highmark, and other support activities to grow additional scale. On occasion, the Practice Leader may also be assigned to internal Highmark projects and functions as required to support a specific business need.

ESSENTIAL RESPONSIBILITIES:

1. The Practice Leader will be accountable for building out a strong consulting workforce to staff the development, design and implementation of complex, transformation changes at a client site. These leaders are accountable to build and grow a robust community of practice. The Practice Leader is accountable to build tools and methods and a consulting workforce that is viewed as top tier in the industry to develop and implement solutions for a diverse client base.  This accountability includes the effective management of team member utilization, program achievement along with effective hiring, growth and development of consultants and consulting managers in the organization.  (25%)

2. Drives delivery monitoring and management of multiple complex projects and programs that span portions of the application.   The portfolio of projects under direct control range from multiple $500K to large multi year efforts that are sometimes greater than $90M.   The average annual portfolio would be $30M - $60M dollars and can go higher when implementing a large client.  The incumbent has accountabilities over multiple projects simultaneously and teams with the Product organization on build activities.    The Practice Leader however maintains the relationship with the customer on all elements of what is being built during the life cycle. (25%)

3. Provides strategic oversight and direction to Practice Leadership (Principals and below) in achieving multi-million dollar program delivery outcomes on time, on schedule, and within budget.   (15%) Leads or assists EHS customers to create and implement internal and external adoption strategies and plans for a complex portfolio of products and programs to achieve desired outcomes. Positions HMHS’s product/service offerings in manner appropriate to each customer. May provide advice to EHS customer in negotiating and managing strategic vendor relationships including agencies, spokespeople, and Consultants as it relates to customer’s use and application of EHS’s capabilities.  Develops and delivers insightful presentations and strategies to the business unit and executive committee where appropriate. (20%)

4. Develops strong market intelligence and relationships required to influence EHS Customers’ internal planning processes to ensure that future capabilities are surfaced and considered responsive to the 1-3 year advanced market needs of EHS customers. (15%) 

4.Other accountabilities as assigned

Minimum Qualifications

  • Bachelor's degree with 10-20 years of management and or consulting experience.
  • Deep, proven expertise in multi-functional management, strategy development and/or integrated tactical implementation for complex, large initiatives.
  • Experience developing business cases and/or comprehensive presentations to executive- and board-level leaders

Preferred Qualifications

  • MBA or other Master's degree in related discipline
  • Registered Clinician
  • Extensive clinical experience in a heath plan environment
  • Highmark functional leadership accountabilities preferred but not required
  • Proven success in launching or executing large-scale and change-oriented initiatives, new products/services or other high-visibility or high-risk initiatives.
  • Understanding of software product / capability management, lifecycle and build processes
  • Understanding of consultative selling practices.
  • Recognized personal expertise by BCBSA or other industry forums

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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