Company :Highmark HealthJob Description :
JOB SUMMARY
This job provides meaningful, strategic consultation to internal stakeholders to assist them in development and implementation of effective client/member clinical solutions to optimize the engagement of members and therefore prevent adverse risk migration. The incumbent collaborates closely with internal business partners to administer population health and clinical initiatives/programs to the customer audiences through effective project management, collaboration and application of best practices and engagement.
ESSENTIAL RESPONSIBILITIES
- Collaborate with internal partners to create and execute wellness and clinical strategies that increase client/member engagement, enrollment, and/or satisfaction in programs and initiatives. Facilitate operational aspects of clinical solutions such as reward program design/set up, quality checks, etc.
- Serve as Subject matter expert to educate, consult, and provide tailored recommendations to internal stakeholders on all resources, content, processes, timelines, fees, and program components.
- Analyze and compile data, trends, and best practices to recommend specific client focused solutions or interventions to achieve outcomes.
- Work collaboratively within the organization to demonstrate and share best practices and client successes. Proactively reach out for and utilize services across the enterprise to deliver and ensure a positive, differentiated customer experience. Build trust and maintain relationships to ensure the success of programs and key initiatives.
- Provide standardized communication materials, reference materials, resources, and implementation support for clinical solutions. Responsible for content creation, identification of customer needs, development, and effective utilization of wellness/population health campaigns and initiatives designed to maximize member engagement and prevent adverse risk migration.
- Investigate and respond to customer inquiries, resolving issues related to offerings in a timely and accurate manner ensuring excellent customer outcomes and satisfaction.
- Proactively lead special projects, workgroups, and initiatives to enhance wellness and clinical offerings and streamline business processes.
- Other duties as assigned or requested.
EXPERIENCE
Required
- 3 years in a clinical, community, or worksite health promotion setting
Preferred
- 3 years of program planning/development, project management and implementation, applying technology and analyzing/evaluation of outcomes
- 1 year in the Health insurance industry
SKILLS
- Experience working in a highly matrixed and complex management structure
- Ability to embrace change management, work effectively in a fast-paced environment while managing multiple complex initiatives
- Analytical evaluation and interpretation of data
- Excellent written, interpersonal, communication and presentation skills
- Strong organizational and time management skills
- Effective problem solving and decision making skills
- Proficiency in use of Microsoft Office products, vendor tools, and organizational systems
LICENSES or CERTIFICATIONS
Required
- None
Preferred
- Registered Dietician
- Registered Nurse
EDUCATION
Required
- Bachelor's Degree in Exercise Science, Nutrition, Nursing, Public Health or other related Clinical field
Substitutions
- 6 years of related and progressive experience in lieu of Bachelor's degree
Preferred
- None
Language (Other than English):
None
Travel Requirement:
0% - 25%
PHYSICAL, MENTAL DEMANDS and WORKING CONDITIONS
Position Type
Office- or Remote-based
Teaches / trains others
Occasionally
Travel 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
No
Lifting: up to 10 pounds
Constantly
Lifting: 10 to 25 pounds
Occasionally
Lifting: 25 to 50 pounds
Rarely
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:
$57,700.00
Pay Range Maximum:
$107,800.00
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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For accommodation requests, please contact HR Services Online at [email protected]
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Top Skills
What We Do
Highmark Health, a Pittsburgh, PA based enterprise that employs more than 40,000 people who serve millions of Americans across the country, is the second largest integrated health care delivery and financing network in the nation based on revenue. Highmark Health is the parent company of Highmark Inc., Allegheny Health Network, and HM Health Solutions. Highmark Inc. and its subsidiaries and affiliates provide health insurance to nearly 5 million members in Pennsylvania, West Virginia and Delaware as well as dental insurance, vision care and related health products through a national network of diversified businesses that include United Concordia Companies, HM Insurance Group, and Visionworks. Allegheny Health Network is the parent company of an integrated delivery network that includes eight hospitals, more than 2,800 affiliated physicians, ambulatory surgery centers, an employed physician organization, home and community-based health services, a research institute, a group purchasing organization, and health and wellness pavilions in western Pennsylvania. HM Health Solutions focuses on meeting the information technology platform and other business needs of the Highmark Health enterprise as well as unaffiliated health insurance plans by providing proven business processes, expert knowledge and integrated cloud-based platforms.
A national blended health organization, Highmark Health and our leading businesses support millions of customers with products, services and solutions closely aligned to our mission of creating remarkable health experiences, freeing people to be their best.
Headquartered in Pittsburgh, we're regionally focused in Pennsylvania, Delaware, West Virginia and New York, with customers in all 50 states and the District of Columbia.
We passionately serve individual consumers and fellow businesses alike. Our companies cover a diversified spectrum of essential health-related needs, including health insurance, health care delivery, population health management, dental solutions, reinsurance solutions, and innovative technology solutions.
We’re also proud to carry forth an important legacy of compassionate care and philanthropy that began more than 170 years ago. This tradition of giving back, reinvesting and ensuring that our communities remain strong and healthy is deeply embedded in our culture, informing our decisions every day.
