VP Care Analytics

Company :

Highmark Health

Job Description : 

JOB SUMMARY

The VP Care Analytics will serve as the key strategist to shape and drive the enterprise's approach to assessing and analyzing all aspects of health (clinical, social and mental). They will act as a key interface to internal and external clinical leaders and other senior executives leading strategies around various aspects of health (e.g., behavioral health, chronic condition management, social determinants). This role is accountable for ensuring common approaches for analyses that are shared across business units, building enterprise-wide tools, and enhancing the ability to attract top technical talent. They will also lead teams of data analysts, research statisticians, epidemiologists, and other technical teams conducting analytics across domains including, but not limited, to identification of opportunities to improve care, reduce total costs of care, population health, clinical variability/ appropriateness of care, quality/ safety/ value, monitoring and evaluation of care outcomes, social determinants of health, and research across the entire spectrum of health. This enterprise role will establish trackable care outcomes and opportunities to improve health, enhance outcomes, and increase affordability for the enterprise (across both payer and provider).

ESSENTIAL RESPONSIBILITIES

• Lead a group of analytic staff that delivers analytics and insights to support strategies and solutions being driven by our Population Health, Enterprise Clinical and Curated Health leaders. This includes, but not limited to, domains such as Clinical Variability and Right Care, Health Outcomes, and Clinical Innovation and Research.

• Develop and maintain a strategic multi-year analytic roadmap for the analytic domains for which they have accountability. This includes regularly gathering inputs from clinical leaders both within Highmark and our Provider Partners, market-leading vendors, key opinion leaders, etc. Collaborates across Health Plan and Health Systems (both owned and partner) to act as a thought leader around Care and Population Health Analytics.

• Engage senior leaders (e.g., Chief Population Health Officer, Chief Medical Officers, Institute Chairs at AHN, Chief Clinical Transformation Leaders) to understand analytics needs and ensure they are met by the team. Creates and executes standard framework for assessing clinical and care risk, conduct population "tear-downs" to identify actionable interventions, etc.. Regularly engage the executive leadership team in terms of performance, performance drivers and required actions (i.e. KPI's, root cause drivers, mitigation plans). This includes developing new health outcomes metrics that meet our blended strategy. When needed represent the analytics and performance with other key stakeholders, such as the Board, Rating Agencies, External Health System Executives, etc.

• Lead teams that conduct regular retrospective evaluations of clinical programs to validate that value is being captured.  Coordinate with the Population Health and C2V leadership to incorporate the results of those evaluations in our medical cost containment portfolio, product pricing, etc.

• Lead work around “blended” research that uses our unique claims and clinical datasets for publications in high-impact journals.  Collaborate with other enterprise research leaders to submit grant proposals to bring-in additional funding for ongoing blended research efforts.

• 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.

• Represent Highmark externally at various conferences, society meetings, and other interviews/ meetings/ etc.

• Performs other duties as assigned.

EDUCATION

Required

• Bachelor's Degree in Business, Health Analytics, Health Policy & Management, Epidemiology or Health Data Science or related field

• Master's Degree in Business, Health Analytics, Health Policy & Management, Epidemiology or Health Data Science or related field

Substitutions

• None

Preferred

• Doctorate in Business, Health Analytics, Health Policy & Management, Epidemiology or Health Data Science or related field

EXPERIENCE
Required

• 10 years in the Healthcare industry

• 10 years in a management role

Preferred

• 7 years analyzing business problems/needs

• 7 years of strategic planning

• 7 years in Data Analytics

• 7 years of Innovation

LICENSES or CERTIFICATIONS

Required

• None

Preferred

• None

SKILLS

• Proven Leadership skills - ability to motivate others to quickly achieve results in a matrixed environment

• Deep understanding of both payer and provider industry/market trends to develop and champion long term strategies

• Demonstrates the ability to effectively persuade others to listen, commit, and act on a new approach

• Self-Confident with an ability to accept and respond to challenges in a positive manner

• Strong and impactful verbal and written communication skills

• Effectively presents complex topics in a concise manner to audiences at various levels (up to Executive/Board) and in various sizes

• Broad understanding of business issues, metrics, organizational linkages and customer value

• Proven track record of effective interactions and strategic influencing with senior and executive management

• Strong organizational and analytical skills in addition to project leadership and management skills

• Deep understanding of both payer and provider industry/market trends to develop and champion long term strategies

• Demonstrates the ability to effectively persuade others to listen, commit, and act on a new approach

• Self-Confident with an ability to accept and respond to challenges in a positive manner

• Strong and impactful verbal and written communication skills

• Effectively presents complex topics in a concise manner to audiences at various levels (up to Executive/Board) and in various sizes

• Broad understanding of business issues, metrics, organizational linkages and customer value

• Proven track record of effective interactions and strategic influencing with senior and executive management

• Strong organizational and analytical skills in addition to project leadership and management skills

Language (Other than English):
None

Travel Requirement:
0% - 25%

PHYSICAL, MENTAL DEMANDS and WORKING CONDITIONS

Position Type
Office-based

Teaches / trains others regularly
Occasionally

Travel regularly from the office to various work sites or from site-to-site
Rarely

Works primarily out-of-the office selling products/services (sales employees)
Never

Physical work site required
Yes

Lifting: up to 10 pounds
Constantly

Lifting: 10 to 25 pounds
Occasionally

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.

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.

Pay Range Minimum:

$198,900.00

Pay Range Maximum:

$412,500.00

Base pay is determined by a variety of factors including a candidate’s qualifications, experience, and expected contributions, as well as internal peer equity, market, and business considerations.  The displayed salary range does not reflect any geographic differential Highmark may apply for certain locations based upon comparative markets.

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 any category protected by applicable federal, state, or local law.

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