VP Clinical Service Business Planning & Operations – Remote

This job is responsible for building and deploying the global workforce and vendor strategy across Clinical Services, creating a clear linkage between business unit needs and the overall strategy.

Accountable for the development of a strategic multi-year global workforce road map and building trackable outcomes and cost avoid metrics.

Responsible for overseeing the budget, financial impact and planning activities for clinical, inclusive of budget performance trending and admin cost target tracking.

Will lead a variety of business planning efforts and collaborate with SME executives related to new programs and growth within Clinical Services including new plan acquisitions, partnerships with other blues, new plan products and/or new market entry.

Leads the STI planning process for clinical services.

Actively run prioritization of work to ensure it aligns with strategic needs, value creation and impact.

ESSENTIAL RESPONSIBILITIES

• Responsible for building and deploying the global workforce and vendor strategy across Clinical Services, creating a clear linkage between business unit needs and the overall strategy.

Accountable for the development of a strategic multi-year global workforce road map and building trackable outcomes and cost avoid metrics.

Ensures the right mix and selection of vendors for Clinical and manages the global offshore relationships.

Engages in opportunities as needed or requested to expand our global workforce portfolio with existing and new solutions.

Serves as the escalation point between the day to day appropriate leader and offshore vendor as it relates to unresolved issues.

Accountable for manaing the direction and performance of the larger relationship across all of Clinical Services.

Serves as the primary representative for all global business activity and vendor activities.

Also serves as the primary interface for the VMO and ensuring peak performance of onshore vendors. 

• Leads a variety of business planning efforts related to health plan growth that affects Clinical Services, inclusive of new plan acquisitions, partnership with other blues, new plan products, and/or new market entry.

Coordinates key activities across all areas of clinical including engage/partner with VP and director SMEs as apporiate to meet deadlines and ensure sustainability of offered solutions.

Validates financial assumptions, administrative support projections and any potential compliance indications to ensure the clinical teams are well positions to perform.

Collaborates with Clinical executive team on business planning, analysis and validation of pricing needs for new B2B capabilities to ensure success of new endeavors.

• Leads the STI planning process for Clinical Services, inclusive of the deliverables and ROI for clinical services initiatives and serves as the primary contact for the strategic portfolio team.

• Oversee the development and annually updates a long-range financial plan for Clinical Services that supports the organization’s overall strategic plans and objectives.

Monitor financial operations to ensure that the organization utilizes its resources in a fiscally responsible manner so as to assure the facility’s long-term sustained success in the future.

• Perform management responsibilities including, but 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.

• Other duties as assigned or requested.

EDUCATION

Required

• Bachelors Degree in Finance, Business or related field

Substitutions

• None

Preferred

• Masters Degree in Business

EXPERIENCE

Required

• 10 years in the Healthcare Industry

• 10 years in a management or leadership role

• 7 years of Financial Acumen (P&L)

Preferred

• 7 years with analysis of business problems/needs

• 7 years of Strategic Planning

• 7 years of Program Management

LICENSES or CERTIFICATIONS

Required

• None

Preferred

• None

SKILLS

• Proven Leadership skills
– ability to motivate others to quickly achieve results in a matrixed environment

• Deep understanding of both payer and provider industry/market trends to develop and champion long term strategies

• Demonstrates the ability to effectively persuade others to listen, commit, and act on a new approach

• Self-Confident with an ability to accept and respond to challenges in a positive manner

• Strong and impactful verbal and written communication skills

• Effectively presents complex topics in a concise manner to audiences at various levels (up to Executive/Board) and in various sizes

• Broad understanding of business issues, metrics, organizational linkages and customer value

• Proven track record of effective interactions and strategic influencing with senior and executive management

• Strong organizational and analytical skills in addition to project leadership and management skills

• Deep understanding of both payer and provider industry/market trends to develop and champion long term strategies

• Demonstrates the ability to effectively persuade others to listen, commit, and act on a new approach

• Self-Confident with an ability to accept and respond to challenges in a positive manner

• Strong and impactful verbal and written communication skills

• Effectively presents complex topics in a concise manner to audiences at various levels (up to Executive/Board) and in various sizes

• Broad understanding of business issues, metrics, organizational linkages and customer value

• Proven track record of effective interactions and strategic influencing with senior and executive management

• Strong organizational and analytical skills in addition to project leadership and management skills

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

• Frequently

Works primarily out-of-the office selling products/services (sales employees)

• Rarely

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, 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, religion, sex, national origin, sexual orientation/gender identity, protected veteran status or disability.

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.