Director, Market Strategy & Analytics

Job ID: J123997
Company: Highmark Inc
Location: Pittsburgh, PA, United States
Full/Part Time: Full time
Job Type: Regular
Posted at: Jun 5, 2018

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Description

JOB SUMMARY

This job helps to develop and leads the execution of the market network strategy for Senior Markets. Determines the Organization's relative position within markets. Ensures network strategies support market, profitable growth, and retention. Drives execution across the organization. Leverages market intelligence and multi-dimensional profitability data to establish and execute a market network strategy for Senior Markets across all geographies in order to grow Medicare Advantage (MA) membership and meet Health plan contribution margin goals. Collaborates with Senior Markets Product, Provider Network & Reimbursement, Clinical and Analytic functions to set parameters for measuring the success of network strategies and tactics. Leads the development and use of multi-dimensional analytics used to inform the overall market strategy/positioning. Leveraging an analytical base of member, product/network and channel profitability, this job contributes to the overall market approach and positioning. Close collaboration with key functional matrix partners is critical for on-going success, including Enterprise Analytics, Actuarial and Provider Contracting and Value Based Reimbursement teams. This job is external facing with provider partners as the primary stakeholders.

ESSENTIAL RESPONSIBILITIES

  • Perform management responsibilities including, but not limited to: involved in hiring and termination decisions, coaching and development, rewards and recognition, performance management and staff productivity.  Plan, organize, staff, direct and control the day-to-day operations of the department; develop and implement policies and programs as necessary; may have budgetary responsibility and authority.
  • Lead matrixed partners in the development of MA specific micro-market strategies across all markets, as well as the development and execution of Value Based and Gain Share network strategies.  Facilitate all aspects of network strategy and implementation.
  • Drive advanced multi-dimensional business and market analytics. Utilize analytics to determine profitability in member, product, channel, and geographic market segments.  Use this analysis to determine adjustments that could be made in care management, network, etc. to improve position.
  • Utilize analytics to guide the market strategy to the optimal intersection of member, product/network (including metal tiers and other plan designs), rate and channel. Consider and incorporate competitor information, financial performance, and functional strategies of matrixed partners.
  • Monitor market developments (e.g., competitors’ regulators) and ensure appropriate inclusion in all aspects of market network strategy. Understand implications of these developments and take actions accordingly.
  • Develop and monitor network performance dashboard and MA performance for provider gain share agreements.
  • Other duties as assigned

EDUCATION

Required

  • Bachelor's Degree in Business Administration/Management

Substitutions

  • None

Preferred

  • Master's Degree in Business Administration/Management

EXPERIENCE

Required

  • 7 - 10 years in Consulting, the Healthcare Industry, Provider Payment/Reimbursement or Medicare

To include

  • 5 - 7 years in Management

Preferred

  • 5 - 7 years in Data Analytics or Network Planning

LICENSES AND CERTIFICATIONS

Required

  • None

Preferred

  • None

SKILLS

  • Analytics
  • Business Consulting
  • Communication Skills
  • Collaboration
  • Medicare Advantage
  • Problem Solving & Decision Making

Language (Other than English)

None 

Travel Required

0%  - 25%


PHYSICAL, MENTAL DEMANDS and WORKING CONDITIONS

Position Type

Office-Based

Teaches / trains others regularly

Frequently

Travel regularly from the office to various work sites or from site-to-site

Rarely

Works primarily out-of-the office selling products/services (sales employees)

Never

Physical work site required 

Yes

Lifting: up to 10 pounds

Constantly

Lifting: 10 to 25 pounds

Occasionally

Lifting: 25 to 50 pounds

Rarely

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 job 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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