JOB SUMMARYThis job will serve as the clinical dyad to the provider partnerships market leader. This incumbent is accountable for the clinical aspect of opportunity identification, design, readiness, and adoption of the living health solutions and programs to reinvent health. The Incumbent will manage clinical capability assessments and interaction with provider systems to determine feasibility and consistency of adopting best practice approaches to achieve the best health outcomes. Will identify new opportunities based on clinical insights, define meaningful interventions and lead communication and change management support. The incumbent will partner with the provider leaders to ensure expert clinical resources and other provider partner resources needed for an effective implementation and transformation process are deployed.
ESSENTIAL RESPONSIBILITIES- Serve as the clinical dyad to the living health partnership market leader and co-lead the coordination of solution opportunity, design, readiness, and adoption at provider partners.
- Represent the clinical point of view on
- All decisions related to the identification, build-out and management of solutions at provider partners.
- Opportunities to incorporate solutions from provider partners into Living Health.
- Serve as an ambassador for Highmark Health and its strategy to provider partners in the context of this role.
- Assist in the development of the implementation framework, playbook, and approach for bringing innovative clinical solutions to provider partners.
- Work with clinicians and administrators to identify key variability challenges and engage appropriate clinical expertise across multiple provider systems for validation and involvement in the process of solution design.
- Partner with the living health partnership market leader on program and clinical process adoption, activation of onsite work streams, and engagement of administration across provider partners.
- Develop and enhance clinical leadership relationships with community hospitals, independent physicians and clinically integrated networks (CINs) in the region, to expand and solidify the presence of Highmark Health.
- Provide other clinical duties as assigned within the enterprise.
EDUCATIONRequired- Doctor of Medicine (MD) or Doctor of Osteopathic Medicine (DO)
SubstitutionsPreferredEXPERIENCERequired- Practicing physician with at least 10+ years clinical practice
- Board Certified physician with a current, unrestricted medical license in any US State
- Demonstrated record of clinical leadership, including experience leading multi-disciplinary clinical teams and multi-specialty physician groups
- Experience working in a highly matrixed clinical structure
PreferredLICENSES or CERTIFICATIONSRequired- Current MD or DO; Must hold a current board certification in field of study
PreferredSKILLS- Successfully partners through collaboration and sense of urgency regarding process implementation and improvement/optimization.
- Experience in matrix management, including own function and providing matrix oversight to others
- Ability to critically appraise and apply the latest medical evidence to inform clinical pathways and care models
- Strong analytical skills to identify complex clinical and operational challenges and develop innovative solutions
- Experience with Value Based Care programs and the needed population health infrastructure, quality processes and care management support to be sucessful
- Ability to understand and interpret complex healthcare data (e.g., claims data, EHR data, quality metrics) to identify trends, opportunities, and areas for improvement. Utilization of data to inform clinical strategy, measure outcomes, and demonstrate value.
- Understanding the financial drivers of healthcare, including reimbursement models, cost-effectiveness, and resource allocation. Capacity to evaluate the financial impact of clinical transformation initiatives to inform financial modeling
- Highly motivated with exceptional organizational skills, including the ability to effectively and competently handle multiple responsibilities simultaneously and the flexibility and ability to quickly adapt to changes in work objectives, promotions, and available technology
- Demonstrated success in building organizational consensus and leading by influence
- Strong oral and written communication skills, can visually convey concepts
- Ability to present complex concepts clearly and concisely to a wide range of audiences
- Exhibits problem solving skills and productively manages conflict
Language (Other than English):None
Travel Requirement:0% - 25%
PHYSICAL, MENTAL DEMANDS and WORKING CONDITIONSPosition TypeMost On-the-Road
Teaches / trains others regularly
Occasionally
Travel regularly from the office to various work sites or from site-to-site
Frequently
Frequently
Physical work site required
Yes
Lifting: up to 10 pounds
Constantly
Lifting: 10 to 25 pounds
Occastionally
Lifting: 25 to 50 pounds
Never
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.
