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J190823

Manager, Clinical Transformation Analytics

Highmark Health

Company :

Highmark Health

Job Description : 

JOB SUMMARY

This job is accountable for leading analytics that identify actionable opportunities and/or create analytics and reporting solutions to improve clinical and population health, enabling Highmark to address strategic priorities which align to the Quadruple Aim: lower per capita health care costs, improved quality of care received, optimal member/patient and provider experiences with care delivery. The incumbent will staff team to ensure the appropriate mix of consulting, analytic, and support functions. Will also provide technical support to internal and external customers, assist senior management decision makers, and ensure that team members are adequately trained to utilize industry standard methodologies and analytic implementation.

ESSENTIAL RESPONSIBILITIES

  • Perform management responsibilities to include, but are 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.
  • Collaborate effectively with clinical, administrative, operational, financial and technical stakeholders to ensure analytics identify actionable improvement opportunities and/or create analytics and reporting solutions and are aligned with execution of organizational strategic priorities, plans and resources.
  • Facilitate the creation of analyses, metrics and reports that support the evaluation of outcome measures using all available clinical, member financial and administrative data. Lead analytics teams to develop analyses, metrics and reporting to monitor strategic and operational goal progress and delivers focused and actionable reporting to internal customers across the enterprise.
  • Develops and executes the vision for where and how the team can bring sophisticated insights and best-in-class analytics by defining the strategic roadmap and execution plan.
  • Partner with clinical, administrative, financial and technical leaders to provide thought leadership and strategic thinking for the structure of analytics initiatives for population health through demonstrating both expertise and execution with robust analysis and clinical and financial data integration.
  • Other duties as assigned or requested.

EDUCATION


Required

  • Master's Degree in Public Health, Nursing, Economics, Health Sciences, Informatics, Biostatistics, Statistics, Epidemiology or Pharmacy


Substitutions

  • 9 years of related and progressive experience in lieu of a Master’s Degree


Preferred

  • Doctorate in Medicine, Public Health, Nursing, Economics, Health Sciences, Informatics, Biostatistics, Statistics, Epidemiology or Pharmacy


EXPERIENCE


Required

  • 5 years of leading and managing analytics teams and providing support to senior and executive leadership

  • 5 years with Business intelligence, analytical software, systems, tools and processes using claims, clinical, enrollment and provider data

To Include

  • 3 years of project leadership in a complex, matrixed environment (payer and/or provider preferred)
  • 3 years in a management or leadership role

Preferred

  • None

LICENSES or CERTIFICATIONS


Required

  • None

Preferred

  • Medical Doctor (MD)

  • Registered Nurse (RN)

  • Nurse Practitioner (NP)


SKILLS

  • Demonstrated record of data-driven discovery, intense intellectual curiosity, and a passion for working with data to answer important questions about population health that drive the Quadruple Aim

  • Strong working knowledge of coding languages, relational databases, quantitative and qualitative analytic methodologies, advanced analytics and statistics

  • Excellent communication and facilitation skills with project team members, stakeholders, executives, and external customer, exceptional written and oral presentation skills, proven ability to communicate interpersonally and technically with technical and non-technical, and internal and external audiences, and the ability to lead through influence

  • Healthcare industry expertise and experience, knowledge about the shifting healthcare environment including trends concerning health insurance, healthcare delivery, provider relationships and regulatory issues

  • Sophisticated knowledge of how organizations work and how to get things done through formal and informal channels

  • Exhibition of perseverance through energy, drive and demonstrated success when resistance or setbacks are encountered

  • In-depth understanding of and experience with both clinical and business processes, and the ability to identify opportunities for improvement and develop solutions

  • Demonstrated ability to lead matrixed teams of technical, clinical, administrative, financial and operational staff to achieve shared organizational objectives and strategic goals


Language (Other than English):

None

Travel Requirement:

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

Occasionally

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

Never

Physical work site required

No

Lifting: up to 10 pounds

Constantly

Lifting: 10 to 25 pounds

Rarely

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.


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


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