Skip To Content
Laptop
J190573

Director Integrated Provider Partnerships

Highmark Health

  • Company Hignmark Health
  • Wilmington, DE
  • Provider Services
  • Full time
  • Day (United States of America)

Company :

Highmark Health

Job Description : 

JOB SUMMARY

As part of the role, the incumbent should be able to set strategic direction, lay out a clear implementation plan for execution, be responsible
for providing direction to their team, collaborate across the business to align other business owner’s efforts, and supporting market-facing
activities.

This position is accountable to partner with organizational executives, functional stakeholders, and workstream team leaders to direct and prioritize all functional daily operating activities across the partnership.  The incumbent ensures all activities, goals and metrics are aligned and working in unison within the core operating model structure to deliver the strategic and operational objectives for maximum partnership realization and value-based healthcare transformation. Oversees the development and implementation of the workplan and core operating model processes, standard operating procedures and all related strategic and operational metric dashboards. Responsible for communicating and interfacing effectively with all levels of the organization, including steering committees, executives and operational teams to actively represent organizational mutual best interests in the partnership. Works closely across all aspects of the each organizations’ functional business units, including the marketing, sales, finance, HR, legal, product, provider network, IT, data analytics, operations, clinical programs, reimbursement, and commercialization functions to gain consensus and incorporate necessary strategic plan and core operations modifications. Set goals for each functional teams within the partnership and holds all team members accountable for specific targets as it relates the strategy, workplan and operations.  This position also leads the identification of market and partnership needs, analyzing, developing and implementing transformative, innovative data-driven, clinical-led, technology enabled, digital-first solutions to decrease medical cost, increase clinical outcomes . Responsible to work with the financial team to ensure annual operational budget forecasting and tracking. 
 

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.
  • Partner closely with the partner provider c-suite executive team and established shared governance committees to lead the strategy development and execution of the integrated provider partnership business plan that supports the long-term partnership objectives and overall partnership strategy.
  • Develop, execute, and manage the multi-year post-affiliation/partnership business plan and strategy execution in deep collaboration with partner provider team resources and executives.  Lead the Business Development team in the development of the business case, financial modeling, valuation, due diligence, deal structuring and negotiation to deliver executed deals.
  • Lead the identification and assessment of strategic integrated provider partnership opportunities to advance the Organization's near- and long-term goals through partnerships, alliances, physician acquisitions, and other business/asset development activities.
  • Develop and maintain relationships across a broad sphere of influence within the Organization and integrated provider partners, including internal stakeholders, executives and management teams of our provider partners, independent physician practices, and other external contacts to achieve business development and partnership objectives. Represent the Organization as an integrated payer partner of choice at external meetings, conferences, and industry events.
  • Lead cross-functional project deal teams that engage key internal stakeholders and external partners (legal counsel, external experts etc.) to ensure successful partnerships.
  • Manage a portfolio of alliances, monitoring the successful execution of our alliances and partnered programs directly.
  • Lead impasse resolution and serve as direct contact for partner executives as necessary.
  • Other duties as assigned or requested.

QUALIFICATIONS

Minimum

  • Bachelor’s Degree in Business or Health Administration or other related area
  • 7 years' of healthcare provider delivery system or healthcare insurance experience
  • 5 years' of management experience, with direct experience working with provider-related contracting and partnership models

Preferred

  • Master’s Degree
  • Previous knowledge of informatics and data analytics

Skills

  • In depth understanding of the Organization’s provider community, particularly in Western PA
  • Knowledge of reimbursement methodologies and models
  • Global understanding of care delivery models and provider alignment, across both payor and provider
  • Experience interacting with providers in the market (negotiating/contracting experience)
  • Ability to work effectively across functions and with the senior executive leadership team
  • Strong analytical and interpersonal skills
  • Presentation skills and a proven ability to communicate detailed information to healthcare executives and physicians
  • Reimbursement, financial and analytical modeling
  • Strong project management skills including the ability to manage multiple projects and meet concurrent deadlines

SCOPE OF RESPONSIBILITY

Does this role supervise/manage other employees?

Yes

WORK ENVIRONMENT

Is Travel Required?

Yes

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.

As a component of job responsibilities, employees may have access to covered information, cardholder data, or other confidential customer information that must be protected at all times. In connection with this, all employees must comply with both the Health Insurance Portability Accountability Act of 1996 (HIPAA) as described in the Notice of Privacy Practices and Privacy Policies and Procedures as well as all data security guidelines established within the Company’s Handbook of Privacy Policies and Practices and Information Security Policy. Furthermore, it is every employee’s responsibility to comply with the company’s Code of Business Conduct. This includes but is not limited to adherence to applicable federal and state laws, rules, and regulations as well as company policies and training requirements. 

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.

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, age, 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, age, religion, sex, national origin, sexual orientation/gender identity, protected veteran status or disability. 

EEO is The Law

Equal Opportunity Employer Minorities/Women/Protected Veterans/Disabled/Sexual Orientation/Gender Identity ( https://www.eeoc.gov/sites/default/files/migrated_files/employers/poster_screen_reader_optimized.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 contact HR Services Online at HRServices@highmarkhealth.org

California Consumer Privacy Act Employees, Contractors, and Applicants Notice


Thumbnail Join Talent Community@2X

Connect with a career that’s right for you.

Introduce yourself and we'll get in touch monthly to share career insights and company news.

Join Our Talent Community