Clinical Transformation Consultant - Central PA/Lehigh Valley

Company :

Job Description : 

JOB SUMMARY

The job works directly with network providers to champion provider practice transformation in support of various Organization endorsed strategic care delivery models. Leads the day to day execution of projects, initiatives and significant work streams related to provider transformation and performance excellence in various health care delivery settings. The incumbent serves as the primary catalyst in identifying and facilitating change in the form of industry standard evidence-based best practice improvement opportunities that are required to accelerate the achievement of goals related to clinical operations excellence and optimal, sustained patient care (as manifested by patient outcomes).

ESSENTIAL RESPONSIBILITIES

• Provide hands on consultative and training services to assigned network providers and/or provider organizations including hospitals, primary care practices, specialty care practices, ancillary providers to facilitate and direct transformation activities geared towards meeting the goals of all required care delivery models.   This is completed via baseline provider performance/practice analysis, gap assessment, team facilitation, transformation plan development, fostering of collaborative relationships between care providers and suppliers, oversight and development of educational and process improvement tools and resources required to promote the attainment of provider specific goals.  
• Carry out the required consultative services via on-site field work, as well as, via various modes of off-site training models such as webinars, video conferences, etc.
• Plan and facilitate the implementation of provider site based projects and initiatives overseeing the acceleration and dissemination of best practice activities throughout the organization to ensure organizational alignment.
• Act as project lead to ensure all deliverables are met and provide on-going recommendations for clinical transformation and operational excellence that improves the provider opportunities for successful transformation and the Organization’s opportunities for achievement of strategic goals related to care delivery and improved member outcomes.
• Identify all relevant opportunities to advance and highlight provider performance strategies and accomplishments via presentations in diverse forums or publishing opportunities.
• Operate with the highest levels of autonomy and independence.
• Demonstrate an expert level of knowledge in facilitating and advancing projects.
• Contribute to the identification and pursuit of opportunities for process improvements and innovations.
• Coordinate significant corporate resources as a means of achieving results.
• Interface with internal stakeholders as subject matter experts of the department’s strategic efforts.    
• Serving as the interface between the various departments/data sources and the provider network (hospitals, health systems, ancillary services, primary care physicians and specialists).
• Utilize training tools, protocols and resources to implement network wide benchmarking and best practices to identify opportunities to reduce unnecessary variation in provider practice patterns, contain care costs and improve clinical outcomes.  
• Solve unique and varied business problems that require risk assessment, sound business judgment and change management skills.  
• Provide solid, actionable recommendations as to what he/she feels is the appropriate decision.
• Develop and maintain strong collaborative relationships with administrative and physician/clinical leaders of provider organizations, provider staff and all internal and external constituents to ensure concerns of all impacted parties are being considered in the transformation activities.   This may include drafting letters on behalf of senior management, creating program manuals and training documentation, assembling pay-for-performance or other program achievement summaries and other documents that will be used within the company as well as by providers, group accounts, and the media.  
• Other duties as assigned or requested.

QUALIFICATIONS

Minimum

• Bachelor’s Degree in a clinical or business discipline or relevant experience and/or education as determined by the company in lieu of bachelor's degree
• 5-7 years of experience in the healthcare industry (hospital clinical operations/management, physician practice management or clinical operations, ancillary provider management or clinical operations, and/or health insurance) with significant knowledge of and experience with various care delivery models
• Experience in health plan provider network performance management, care/c