Company :

Highmark Inc.

Job Description :

JOB SUMMARY

This job is responsible for connecting the needs of target Growth Government Markets program requirements with the organizational business strategy and operations in order to activate new Government Markets. The incumbent defines and sharpens value propositions through solution identification and requirements gathering for new markets, products and services as reflected in go-to-market strategy and Requests for Proposals (RFPs), focused largely on Medicaid, Long Term Services and Supports, and Dual Special Needs Programs. As leader of the Government Markets Growth Center of Excellence, this job has overall accountability for defining and refining Highmark Health Plan’s go to market approach and business requirements across all functional areas including products, networks, reimbursement, clinical services, and health plan operations in a powerful and compelling way that establishes competitive advantage versus the competition and meets financial objectives.

ESSENTIAL RESPONSIBILITIES

• 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.

• Develop and implement an implementation and activation process from design hand-off to assembling the implementation team to implementation and hand off.

• Has overall accountability for partnering with business owners to define and refine Highmark Health Plan’s go-to-market activation solutions, plans and requirements for our products, networks, reimbursement, clinical services, and operations in a powerful and compelling way that aligns to strategic approach. Define and sharpen value propositions and clear tactical approach for Health Plan products and services as reflected in business case strategies.

• Work with Business owners to help triage and organize the appropriate stakeholders in the Health Plan to help solve customer issues in advance of an RFP coming in house. Once the RFP is in-house, help to organize the appropriate leaders and SMEs to ensure suitable answers and narratives are ideally positioned in the RFP.

• Develop an understanding of the trends in the marketplace, available in house solutions, and working with the business and technology to identify solutions where needed. Oversee the capture of all business and compliance requirements to disseminate downstream into the delivery organization where appropriate and support delivery throughout the lifecycle.

• Regularly brief market segment and operational leaders on the trends observed in RFP questions and other sources specific to an approved growth initiative to inform strategic business decisions. Work with leaders of various operational areas to understand what business strategies should be communicated, executed, and prioritized.

• Other duties as assigned or requested.

EXPERIENCE

Required

• 5 years of experience with management or leadership role

• 7 years of experience with deep breadth and depth of business knowledge across relevant functions (product, marketing, operations, etc.) in healthcare or similarly regulated product industries.

• 3 years of experience with healthcare industry

• 3 years of experience with managing and influencing multiple stakeholders simultaneously to achieve desired objectives. Able to garner “buy in” through relationship building skills and expertise.

Preferred

• 3 years of experience with managing large, multi-year initiative program

• Experience in Healthcare/Government Markets (Medicaid preferred)

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SKILLS

• Demonstrated learning agility when faced with complex business and communications challenges.

• Ability to synthesize various workstreams in the enterprise to identify overall strategies and narratives.

• Ability to convert data and insights into salient and persuasive business cases

• Keen eye for detail and ability to design and convey leading edge solutions to transform health.

• Strong oral and written communication skills can visually convey concepts.

• Managing through some levels of ambiguity. Ability to create a function “from scratch.”

• Experience in matrix management, including own function and providing matrix oversight to others.

EDUCATION

Required

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

Preferred

• Master's degree in business administration.

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 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.

EEO is The Law

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For accommodation requests, please contact HR Services Online at HRServices@highmarkhealth.org

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Req ID: J246787