Job Description :
This job will transform the post-acute care space by increasing quality, service, and value for the diverse set of customers we serve. This job will help drive day-to-day strategic efforts focused on development of the HM HCS strategy. This job will drive clinical strategies to meet organizational goals, and demonstrate a thorough understanding of clinical program management principles in support of complex clinical initiatives. The job will be well versed in understanding how integrated approached to care can be delivered to benefit patients.
- Support the Sr. Medical Director in designing clinical program solutions that work to improve/drive patient outcomes in alignment to business objectives and plans. Develop and create improved clinical care strategies that improve patient outcomes.
- Link the development of clinical solutions to the contracting and account management strategies to meet or exceed HM HCS objectives.
- Coordinate clinical program teams to establish processes for measuring and comparing program performance. Assure quality of information through business case and application level testing, and validate results.
- Identify, analyze and interpret appropriate sources of PI data, quality indicators, benchmarks and best practices to ensure the collection of meaningful data demonstrates processes and outcomes of PAC programs.
- Identify, analyze and interpret appropriate sources of PI data, quality indicators, benchmarks and best practices to ensure the collection of meaningful data demonstrates processes and outcomes of post-acute care programs.
- Organize, display and report data in a manner that facilitates the planning, development and evaluation of projects and programs as directed by the Sr. Medical Officer.
- Other duties as assigned or requested.
- Bachelor's Degree in Nursing, Medicine, Science or related discipline
- Master's Degree in Nursing, Science or related discipline
- 8 years in a healthcare setting with complex/matrixed organizations
- 4-6 years leading complex clinical program/projects in a clinical/health care setting
- 5 years developing clinical programs with demonstrated improved clinical quality and outcomes in post-acute care space
LICENSES or CERTIFICATIONS
- Demonstrate leadership skills, and develop, communicate, and implement solutions to meet the needs of the business
- Requires ability to visualize, articulate, and solve highly complex problems/issues
- Knowledge of healthcare structure and operations, utilization and quality improvement
- Excellent written, presentation, and verbal communications skills required for all audience levels/types
Language (Other than English):
0% - 25%
PHYSICAL, MENTAL DEMANDS and WORKING CONDITIONS
Teaches / trains others regularly
Travel regularly from the office to various work sites or from site-to-site
Works primarily out-of-the office selling products/services (sales employees)
Physical work site required
Lifting: up to 10 pounds
Lifting: 10 to 25 pounds
Lifting: 25 to 50 pounds
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, 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.
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