at Highmark Health in Springfield, Illinois, United States
Job Description :
This job oversees the end to end solutioning process from concept through hand off to activation for solutions and is accountable for the ultimate design, performance, and readiness for scale of the portfolio of solutions to be rationalized, optimized, designed, and ultimately personalized and packaged to reinvent health. Partners across the Living Health organization to engage the comprehensive listening system, market and customer/clinician insights, manage solution development roadmaps, and testing and scaling. Partners with a variety of Living Health Clinician dyad partners and the Design Delivery team to ensure expert clinical resources and other enterprise resources needed for an effective design process are deployed consistently in a well-defined matrix reporting structure. Responsible for coordinating teams of project managers, process engineers, designers, partners, and experts to inventory, evaluate, streamline, and design/re-design clinical solutions. Works with clinical, analytic, and business teams to understand the pain points associated with customer journeys and define the correct solutions. Partners with activation teams to craft the project plans to deploy and scale those solutions to customers. Makes formal documentation and recommendations regarding best in class solutions that should be adopted. Once adopted, the role will be accountable for managing vendor relationships and obligations, driving adoption of those solutions, and will be accountable for the performance of the solutions.
+ 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.
+ Leverages design knowledge to collaborate with stakeholders to define, plan, and design the appropriate end-to-end cross-channel experiences and solutions from a customer and clinician point of view to achieve customer engagement, clinician engagement, health outcomes, and affordability targets and in support of scaling curated health model solutions.
+ Develop analytical frameworks, approach and methodology best practices to analyze strategy issues and monitor initiatives. Evaluates new software or technology capabilities, assesses vendor solutions, creates and manages ongoing partnerships with third parties such as digital agencies, software vendors, BCBSA, and other key vendors.
+ Conveys and prioritizes needs from comprehensive listening system in collaboration with Portfolio Insights & Acceleration and other Enterprise teams in the matrix to identify client, customer and clinician needs and expectations to support solution design and personalization.
+ Accesses market intelligence capabilities to understand the market products, innovations, competitor solutions and any aspect of information needed to support the design process.
+ Synthesizes and interprets large amounts of quantitative data to support curated health model solution design, particularly for those solutions targeted at improving health outcomes and affordability.
+ Leads in design sessions with design team, experts and other business partners. Applies a variety of methods and approaches to facilitate problem solving; experiments to find the best solutions.
+ Interprets strategies into visual notional representations and explains the assumptions, approaches and key tenets. Applies an expert understanding of needs, goals, and challenges and connects to tell a single story.
+ Monitors progress of Solution efforts and is accountable for Solution outcomes (ROI, KPIs) and collaborates with Finance to justify resource allocation for solution prototyping and scaling.
+ On an ongoing basis, manages dependencies across Solutions and escalates decisions as needed.
+ Other duties as assigned or requested.
+ Bachelor’s Degree in Business, Design, Healthcare Administration, Economics, Analytics, or related field or relevant experience and/or education as determined by the company in lieu of bachelor’s degree
+ Master’s Degree in Business, Design, Healthcare Administration, Economics, Analytics, or related field
+ 7 years post-graduate experience in the area of specialization, including leading large projects
+ 3 years in Business or Healthcare
+ 5 years with Health Insurance and/or Provider operations
+ 3 years with operational improvement
LICENSES or CERTIFICATIONS
+ Through knowledge of membership, rates, financial, economic and competitive data
+ Excellent written, interpersonal, communication, and presentation skills
+ Highly motivated with exceptional organizational skills, including the ability to effectively and competently handle multiple projects simultaneously and the flexibility and ability to quickly adapt to changes in work objectives, promotions, and available technology
+ Knowledge of software development lifecycle, from planning to delivery
+ Experience developing business cases, and building ROI for programs from planning through execution
+ Ability to lead within a matrixed organization to partner with clinical experts
+ Leads with a true sense of urgency with the ability to engage the workforce to do the right thing every time for our customers and clinicians
+ Successfully parthers through collaboration and sense of urgency regarding process implementation and improvement/optimization
+ Experience using sketches, flow diagrams, wireframes, mockups, prototypes, member experience blueprints, and visual concepts
+ Leads with a customer and clinician-centric lens and advocates for a combined customer and clinician view in all interactions
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