Vice President, Clinical & Provider Analytics

Job ID: J124777
Company: Highmark Inc
Location: Pittsburgh, PA, United States
Full/Part Time: Full time
Job Type: Regular
Posted at: Jun 14, 2018

Share:

Description

General Overview:

The job will have a broad role in the Organization's transformational journey.  The job will be the primary analytical support for the SVP of Clinical Services and the SVP of Provider, Network and Reimbursement.  The incumbent leads several analytical teams that cover such analytical domains as design of the reporting and analytical packages to support providers in Pay 4 Value/ Value Based Reimbursement programs, design and innovation of the Organization's risk stratification approaches (including incorporation of new data sources and predictive modeling), analysis of key utilization metrics, and development of new analytics to support network design and management.  The incumbent will be accountable for leading and guiding their teams that are consulting with senior business leaders to identify opportunities to build self-service tools, design new reports/ analytics, assess program performance, and conduct other innovative analytics that deliver business value. 

Essential Job Functions:

  • 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.
  • Create and implement the right strategy to ensure that the Organization has an innovative, marketing leading suite of analytic and reporting packages for Primary Care Physicians, Specialists, Hospitals and other Ancillary Providers.  These would include incorporation of new data sources (e.g., clinical/ EMR data), predictive modeling, and application of new visualization tools that help providers and their staff turn analytics into action/ impact.   This will include leading the team to build these packages and installation of a continuous improvement process/ mindset to ensure the Organization's analytics stay market leading.
  • Create and implement the right strategy to ensure that the Organization can build and continuously improve a comprehensive set of risk identification and stratification algorithms that will fuel population health programs driven by internal Organization resources (e.g., nurse managers), Provider partners (e.g., Primary Care Professionals) and/ or clinical resources embedded within providers.  This would include guiding and supporting the teams that are continuously searching for new data sources (beyond claims) and continuously testing new analytical techniques to improve the Organization's ability to identify members with rising risks and emerging trends. 
  • Create the right framework to enable standard assessment of physician performance (across cost, quality and other dimensions) and effectiveness of their referral patterns (e.g., social network analysis) to enable the build and continuous monitoring of custom high efficiency networks.  This would include ensuring that the teams continuously integrate new data techniques/ approaches, such as new episode logic and other new care models/ pathway development.
  • Represent the Organization and our analytic capabilities with external Provider partners (both Physicians and Executive Leadership) to ensure they deeply understand current capabilities and are able to provide continuous feedback/ input to ensure the capabilities stay market leading.
  • Other duties as assigned.

Required Education:

  • Bachelor's Degree in Business Administration/Management, Computer Engineering or Actuarial Science

Preferred Education:

  • Master's Degree in Business Administration/Management, Computer Engineering, Mathematics Statistics

Required Experience:

  • 5 - 7 years of Data Analytics experience
  • 5 - 7 years of Management experience

Preferred Experience:

  • 5 - 7 years of Healthcare Industry experience
  • 1 - 3 years of Predictive Modeling 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.
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

Share:

Interested in working at the Highmark Health enterprise?
Take the first step by joining our Talent Network today!

Join Our Talent Network

Similar Jobs

Lead Provider Relations Representative

Home, PA, United States
Provider Services

Physician Relations Manager - Erie

Erie, PA, United States
Provider Services

Associate Provider File Representative

Harrisburg, PA, United States
Provider Services

Manager Provider relations

Home, AR, United States
Provider Services

Vice President, Clinical & Provider Analytics

Pittsburgh, PA, United States
Provider Services

Clinical Transformation Consultant Specialist-Central PA

Home, PA, United States
Provider Services

Lead Provider Relations Representative

Home, PA, United States
Provider Services

Value-Based Innovation Consultant

Pittsburgh, PA, United States
Provider Services

Provider Account Liaison

Camp Hill, PA, United States
Provider Services

Post Acute Network Performance Manager

Pittsburgh, PA, United States
Provider Services

Manager PIM Provider Maintenance

Pittsburgh, PA, United States
Provider Services

Provider Partnerships Consultant

Camp Hill, PA, United States
Provider Services

Director, Provider Partnerships - Penn State Health

Camp Hill, PA, United States
Provider Services

Director Integrated Provider Partnerships

Camp Hill, PA, United States
Provider Services

Manager, Network Development

Pittsburgh, PA, United States
Provider Services

Director, Population Health

Pittsburgh, PA, United States
Provider Services

Population Health Performance Specialist

Pittsburgh, PA, United States
Provider Services

Reimbursement Economics Consultant

Pittsburgh, PA, United States
Provider Services