Company :

Highmark Inc.

Job Description : 

JOB SUMMARY

This job is responsible for activating solutions and ensuring that the intended value of each solution is achieved through thoughtful planning and execution for Government Markets growth initiatives, including market expansion and new market build and implementations.  The incumbent will lead a cross functional group of matrix partners to develop sound business cases to support the realization of our solutions and must have a comprehensive approach to solution activation.  Will be responsible for determining the technical requirements, legal/compliance regulatory considerations, benefit/reimbursement implications, provider partner scaling strategy, as well as a operations and membership scaling strategy to paint a holistic picture of how our solutions will succeed. This job will play a critical role in not only securing funding for a specific solution, but ensuring that our internal and external partners (such as Operations, Technology, sales and provider partners) have what they need to be successful.  The incumbent will work with leaders from across the organization to build out our go to market strategy and ensure that offerings are sequenced, bundled, and positioned in a way to maximize market uptake and lead RFP/RFA responses to ensure Government Markets are delivering winning bids.

ESSENTIAL RESPONSIBILITIES

• Work with business/ market owners to identify key business issues, apply right analytical framework, develop solution and recommendations, represent findings to stakeholders and own the outcome.
•  Manage major strategy projects with the help of internal or external strategy consulting resources.
• Serve as subject matter expert to Strategic Operations staff and stakeholders on membership, growth and operational strategy issues.
• Develop analytical frameworks, approach and methodology best practices to analyze strategy issues.
• Other duties as assigned or requested.

EXPERIENCE

Required

• 5 years of related experience in business, healthcare, or research/analytics to include at least 1 year leading the development and implementation of go-to-market strategies for products and/or service

Preferred

• 2 years of experience with extensive knowledge of health insurance and/or provider operations
• 2 years of experience in operational improvement
• 2 years of experience with thorough knowledge of membership, rates, financial, economic and competitive data
• 2 years of government markets experience (Medicaid, Medicare, D-SNP, CHIP) 

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SKILLS

• Broad application of principles, theories, and concepts in strategic thinking, plus working knowledge of other related fields
• Strong PC application Skills (MS Office including PowerPoint and Excel)
• Knowledge of healthcare industry trends and challenges
• Strong critical thinking skills
• Good communication and presentation skills

EDUCATION

Required

• Bachelor’s degree in business, healthcare, economics or related degree (OR) relevant experience and/or education as determined by the company in lieu of bachelor's degree.   

Preferred

• Master's degree in business, healthcare, economics or related degree

LICENSES or CERTIFICATIONS

Required

• None

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.

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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