Job Information
Highmark Health Clinical Integration and Performance Specialist - Helion in Pittsburgh, Pennsylvania
Company :
Helion
Job Description :
JOB SUMMARY
This job will transform the post-acute care space by increasing quality, service, and value for the diverse set of customers we serve. This job will help drive day-to-day strategic efforts. This job will drive clinical strategies to meet organizational goals and demonstrate a thorough understanding of clinical program management principles in support of complex clinical initiatives. The job will be well versed in understanding how an integrated approach to care can be delivered to benefit patients.
ESSENTIAL RESPONSIBILITIES
Design clinical program solutions that work to improve/drive patient outcomes in alignment to business objectives and plans and create improved clinical care strategies that improve patient outcomes.
Identify, analyze, and interpret appropriate sources of PI data, quality indicators, benchmarks and best practices to ensure the collection of meaningful data demonstrates processes and outcomes of post-acute care programs.
Develop program scope, goals, objectives, and metrics ensuring they align with the organizational strategy.
Drive continuous process improvement activities to enhance performance and reduce costs and identify opportunities to manage processes and care costs in a more effective manner.This should be accomplished by the incumbent playing a vital role in the coordination of activity and decision-making to ensure that day to day operational decisions are made to support the overall goal, vision and desired outcome of the clinical program or solution.
Link the development of clinical solutions to the contracting and account management strategies to meet or exceed HM HCS Helion objectives.
Coordinate clinical program teams to establish processes for measuring and comparing program performance. Assure quality of information through business case and application-level testing and validate results.
Support provider education and resources to ensure adoption of programs.
Organize, display and report data in a manner that facilitates the planning, development and evaluation of projects and programs.
Other duties as assigned or requested.
REQUIRED EDUCATION
- Bachelor's Degree in Nursing, Medicine, Health Science or related discipline
SUBSTITUTIONS
- 5 years of clinical practice, program management or related experience in lieu of bachelor's degree.
PREFERRED EDUCATION
- Master's Degree in Nursing, Science or related discipline
EXPERIENCE
Minimum
5 years of healthcare setting experience with complex/matrixed organization
5 years of leading complex clinical program/projects in a clinical/health care setting
Preferred
- 5 years of Developing clinical programs with demonstrated improved clinical quality and outcomes in post-acute care space.
LICENSES or CERTIFICATIONS
Required
- None
Preferred
- None
SKILLS
Demonstrate leadership skills, and develop, communicate, and implement solutions to meet the needs of the business
Requires ability to visualize, articulate, and solve highly complex problems/issues
Knowledge of healthcare structure and operations, utilization and quality improvement
Excellent written, presentation, and verbal communications skills required for all audience levels/types
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
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 their race, color, age, religion, sex, national origin, sexual orientation/gender identity or any other category protected by applicable federal, state or local law. Highmark Health and its affiliates take affirmative action to employ and advance in employment individuals without regard to race, color, age, religion, sex, national origin, sexual orientation/gender identity, protected veteran status or disability.
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Req ID: J245979
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