CareFirst BlueCross BlueShield

Population Health Strategy Consultant (Hybrid)

CareFirst BlueCross BlueShield$71K — $141K *
Healthcare
Less than 5 years of experience
Job Overview by Ladders

Qualifications

  • Master's Degree in Public Health, Health Administration, Business Administration, or related field, or 6 years of relevant work experience in lieu of a degree
  • 2 years of healthcare experience
  • Consulting skills or experience in a consulting role
  • Experience in a clinical setting or knowledge in a clinical field
  • Project management experience
  • Experience with Client Relationship Management (CRM) System(s)
  • Ability to analyze complex data and develop solutions effectively.

Responsibilities

  • Consult with providers to transform practices and improve patient outcomes
  • Analyze health data to manage value-based contracts and inform decision-making
  • Identify opportunities to enhance patient care access and quality within the local healthcare market
  • Build and manage relationships with health system administrators and stakeholders
  • Recruit providers and negotiate terms of value-based contracts
  • Participate in administrative functions and share best practices
  • Conduct market analysis to understand community health needs.

Benefits

  • Comprehensive benefits package
  • Various incentive programs
  • 401k contribution programs
  • Opportunities for professional development and training
  • Home-based work flexibility with field travel.
Full Job Description
Resp & Qualifications

**This is a field-based position where the incumbent will travel regularly within the Western Maryland region to consult with provider entities in their assigned portfolio. Working from a home-base and traveling through the Western Maryland, the incumbent will be expected to come into a CareFirst location periodically for meetings, training and/or other business-related activities.**

PURPOSE:
The Population Health Strategy Consultant (Western Maryland) works closely with physicians and health systems ("providers") enrolled in CareFirst's commercial and government value-based programs to understand patterns in their population's health data and effectuate practice transformation strategies that improve quality and reduce global health care costs. The Practice Consultant collaborates with internal subject matter experts to provide consulting services to physicians, key physician practice staff, executive level health system administrators, and other stakeholders to achieve program or contract goals.

ESSENTIAL FUNCTIONS:
  • Practice Transformation: Employs consulting skills to manage behavior change and influence practice workflow improvements that optimize outcomes and value. Thoughtfully implements processes and technologies in practices to assure the highest state of provider readiness to participate in various CareFirst networks, government programs and other opportunities that may emerge.
  • Data and Workflow Analysis: Manages aggregate performance of all value-based contracts across the market and develops/adjusts plan as needed. Conducts a thorough review of clients' opportunities, utilization patterns, and outcomes to inform provider and health system decision making. Researches any variances and seeks resolution. Models the financial impact of proposed changes in practice patterns.
  • Market Analysis and Development: Builds and manages relationships within the local health care market, understanding community health and wellness needs. Identifies opportunities to improve the access, quality and efficiency of patient care and provider communication between patient, PCP, specialist and hospital. Recruits providers and negotiates terms of value based contracts, facilitates relationships between key stakeholders, and creating medical neighborhoods that facilitate optimal patient care and communication.
  • Active participation in best practice development and sharing, team activities, and administrative functions.

QUALIFICATIONS:

Education Level: Master's Degree in Public Health, Health Administration, Business Administration, or related field OR in lieu of a Master's degree, an additional 6 years of relevant work experience is required in addition to the required work experience.

Experience: 2 years health care experience.

Preferred Qualifications:
  • Consulting skills and/or direct experience in a consulting role
  • Experience in a clinical setting or knowledge in a clinically related field
  • Project management experience
  • Experience using Client Relationship Management (CRM) System(s)

Knowledge, Skills and Abilities (KSAs)
  • Demonstrated ability to effectively comprehend complex data analysis.
  • Solution development.
  • Executive presentation skills.
  • Effective written and interpersonal communication skills.
  • Effective at building relationships with various levels of business professionals and/or clinicians.
  • Must be able to meet established deadlines and handle multiple customer service demands from internal and external customers, within set expectations for service excellence. Must be able to effectively communicate and provide positive customer service to every internal and external customer, including customers who may be demanding or otherwise challenging.

Travel Requirements
Estimate Amount: 80% Able to travel through assigned region on a daily basis and work in the field the majority of work days.

Salary Range: $71,064 - $141,141

Salary Range Disclaimer

The disclosed range estimate has not been adjusted for the applicable geographic differential associated with the location at which the work is being performed. This compensation range is specific and considers factors such as (but not limited to) the scope and responsibilities of the position, the candidate's work experience, education/training, internal peer equity, and market and business consideration. It is not typical for an individual to be hired at the top of the range, as compensation decisions depend on each case's facts and circumstances, including but not limited to experience, internal equity, and location. In addition to your compensation, CareFirst offers a comprehensive benefits package, various incentive programs/plans, and 401k contribution programs/plans (all benefits/incentives are subject to eligibility requirements).

PHYSICAL DEMANDS:

The associate is primarily seated while performing the duties of the position. Occasional walking or standing is required. The hands are regularly used to write, type, key and handle or feel small controls and objects. The associate must frequently talk and hear. Weights up to 25 pounds are occasionally lifted.

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About CareFirst BlueCross BlueShield

CareFirst BlueCross BlueShield is a regional health insurance company that serves over 3.4 million members in Maryland, the District of Columbia, and Northern Virginia. It is a nonprofit organization and the largest health insurer in the Mid-Atlantic region. The company offers a variety of health insurance plans, including individual and family plans, Medicare plans, and employer-sponsored plans.
Learn more about CareFirst BlueCross BlueShield
Size
5,000 employees
Industry

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