VP Care Analytics

Company :

Highmark Health

Job Description : 

JOB SUMMARY

The VP Care Analytics will serve as the key strategist to shape and drive the enterprise's approach to assessing and analyzing all aspects of health (clinical, social and mental). They will act as a key interface to internal and external clinical leaders and other senior executives leading strategies around various aspects of health (e.g., behavioral health, chronic condition management, social determinants). This role is accountable for ensuring common approaches for analyses that are shared across business units, building enterprise-wide tools, and enhancing the ability to attract top technical talent. They will also lead teams of data analysts, research statisticians, epidemiologists, and other technical teams conducting analytics across domains including, but not limited, to identification of opportunities to improve care, reduce total costs of care, population health, clinical variability/ appropriateness of care, quality/ safety/ value, monitoring and evaluation of care outcomes, social determinants of health, and research across the entire spectrum of health. This enterprise role will establish trackable care outcomes and opportunities to improve health, enhance outcomes, and increase affordability for the enterprise (across both payer and provider).

ESSENTIAL RESPONSIBILITIES

• Lead a group of analytic staff that delivers analytics and insights to support strategies and solutions being driven by our Population Health, Enterprise Clinical and Curated Health leaders. This includes, but not limited to, domains such as Clinical Variability and Right Care, Health Outcomes, and Clinical Innovation and Research.

• Develop and maintain a strategic multi-year analytic roadmap for the analytic domains for which they have accountability. This includes regularly gathering inputs from clinical leaders both within Highmark and our Provider Partners, market-leading vendors, key opinion leaders, etc. Collaborates across Health Plan and Health Systems (both owned and partner) to act as a thought leader around Care and Population Health Analytics.

• Engage senior leaders (e.g., Chief Population Health Officer, Chief Medical Officers, Institute Chairs at AHN, Chief Clinical Transformation Leaders) to understand analytics needs and ensure they are met by the team. Creates and executes standard framework for assessing clinical and care risk, conduct population "tear-downs" to identify actionable interventions, etc.. Regularly engage the executive leadership team in terms of performance, performance drivers and required actions (i.e. KPI's, root cause drivers, mitigation plans). This includes developing new health outcomes metrics that meet our blended strategy. When needed represent the analytics and performance with other key stakeholders, such as the Board, Rating Agencies, External Health System Executives, etc.

• Lead teams that conduct regular retrospective evaluations of clinical programs to validate that value is being captured.  Coordinate with the Population Health and C2V leadership to incorporate the results of those evaluations in our medical cost containment portfolio, product pricing, etc.

• Lead work around “blended” research that uses our unique claims and clinical datasets for publications in high-impact journals.  Collaborate with other enterprise research leaders to submit grant proposals to bring-in additional funding for ongoing blended research efforts.

• 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.

• Represent Highmark externally at various conferences, society meetings, and other interviews/ meetings/ etc.

• Performs other duties as assigned.

EDUCATION

Required

• Bachelor's Degree in Business, Health Analytics, Health Policy & Management, Epidemiology or Health Data Science or related field

• Master's Degree in Business, Health Analytics, Health Policy & Management, Epidemiology or Health Data Science or related field

Substitutions

• None

Preferred

• Doctorate in Business, Health Analytics, Health Policy & Management, Epidemiology or Health Data Science or related field

EXPERIENCE
Required

• 10 years in the Healthcare industry

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