Director Clinical Val Port Mgt
Emergent Holdings

Southfield, Michigan

This job has expired.


SUMMARY: Responsible for planning and execution for Emergient Clinical Value Initiative portfolio, with an emphasis on developing and maintaining multi-year planning and capabilities matrix to guide and inform capital planning process and annual budgeting. This position will also be responsible for managing the value proposition, ensuring that the portfolio creates, delivers, and realizes projected benefits and those benefits (predominantly benefit cost savings, cost avoidance, and improved experience for members for the Emergient market) are accurately communicated back to the business.

RESPONSIBILITIES/TASKS:

Opportunity Ideation and Planning

  • Manage and assist in the development of a pipeline of opportunities with the purpose of achieving clinical value for Emergient health services.
  • Formalize plan for delivery of multi-year initiatives to achieve clinical value and medical cost savings.
  • Work closely with Finance, IT, and Emergient Planning and Strategy functions to ensure efforts are aligned with overall Enterprise and Emerging Markets timelines.
  • Lead annual efforts to support Bid submission for Emergient including, but not limited to:
  • Initiative / capabilities planning
  • Actuary cost savings certification
  • IT and Readiness estimation
Initiative Execution
  • Oversee the execution of projects to achieve clinical value and medical cost savings that have significant implications for Emergient strategic plan and financial targets. These projects have significant visibility with Executive leadership and require position leadership to support the following type of activities:
    • Facilitate executive level discussions and comfortably engage executives to support strategic and tactical objectives of the business
    • Drive execution of program efforts and ensures strong alignment of work efforts
    • Manage issue escalation and resolution
    • Work cross functionally across the organization to drive delivery; spokesperson and representative for the business -- supports education of business objectives, drives structure, and works behind the scenes to get alignment, proactively anticipate issues, and foster communications across teams.
DIRECTION EXERCISED:

Directly supervises exempt and non-exempt staff in accordance with company policies and applicable Federal and State Laws. Responsibilities include, but are not limited to, effectively interviewing, hiring, terminating, and training employees; planning, assigning, and directing work; appraising performance; rewarding and counseling employees; addressing complaints and resolving problems; supporting and encouraging the engagement process.

This position description identifies the responsibilities and tasks typically associated with the performance of the position. Other relevant essential functions may be required.

EMPLOYMENT QUALIFICATIONS:

EDUCATION:

Bachelor's degree in a related field. Master's degree in public health, health care administration or other related field is preferred. Valid Michigan Accident and Health Insurance License required. Valid and unrestricted driver's license required. Relevant combination of education and experience may be considered in lieu of degree. Continuous learning, as defined by the Company's learning philosophy, is required. Certification or progress toward certification is highly preferred and encouraged.

EXPERIENCE:

Ten (10) years of progressively more responsible experience in a Business environment with demonstrated technical experience that provides the necessary knowledge, skills and abilities. Ten years of progressively more responsible industry experience in related field including consulting experience or direct experience leading and managing strategic programs valued at $50+M to the business preferred. 7 to 10 years' experience working in a health insurance plan, health provider organization, or public health or community-based agency in a similar capacity Five (5) years management or supervisory experience in Business required. Bilingual skills preferred.

SKILLS/KNOWLEDGE/ABILITIES (SKA) REQUIRED:
  • Ability to work effectively in a team environment.
  • Ability to work in time sensitive / rapid pace environment with shifting priorities and high exposure to varying levels of the Leadership team (Executive / Senior)
  • Understanding of the Medicare Advantage marketplace and industry trends impacting the business
  • Critical thinking and analytical skills; ability to take loosely formed ideas and information related to strategy and capabilities and drive formalization of related deliverables
  • Analytical skills -- able to support identification of data needed (e.g. numbers / facts / figures) to enhance messaging and support research (organize data, develop charts, tables, etc.)
  • Must demonstrate leadership ability and team building skills to effectively supervise professional and non-professional staff and interact with all levels of management.
  • Strong negotiation skills to influence key stakeholders.
  • Customer management skills.
  • Managerial experience / ability to lead, motivate and cultivate a junior team (including virtual management of teams)
  • Ability to work with and empower others on a collaborative basis (manage in a matrix) to ensure success of unit team (including virtual management of teams)
  • Ability to develop templates or organize data / storyboard discussion objectives and information needed
  • Ability to effectively exchange information, in verbal or written form, by sharing ideas, reporting facts and other information, responding to questions and employing active listening techniques.
  • Ability to effectively present budgetary and/or cost information and respond to questions as appropriate.
  • Ability to establish workflows, manages multiple projects, and meets necessary deadlines.
  • Ability to think cross functionally and broadly about the business
  • Ability to work with team of project managers supporting portfolio of initiatives
  • Microsoft suite with an emphasis on PPT, Excel, Word, Visio, and Project; ability to communicate and synthesize data for executive leadership review and consumption
WORKING CONDITIONS:

Work is performed in an office setting with no unusual hazards. Travel is required.

The qualifications listed above are intended to represent the minimum education, experience, skills, knowledge and ability levels associated with performing the duties and responsibilities contained in this job description.

We are an Equal Opportunity Employer. Diversity is valued, and we will not tolerate discrimination or harassment in any form. Candidates for the position stated above are hired on an \"at will\" basis. Nothing herein is intended to create a contract.


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