Clinical Strategy Analyst

Highmark Health • PA, Working at Home - Pennsylvania, PA

3d • $79,300 - $127,100 • Onsite

About The Position

This job supports the acquisition of new accounts and retention of existing accounts by working directly with client managers within national and regional markets. The incumbent is primarily accountable for clinical analysis and preparation of reporting metric deliverables for Highmark customers, including healthcare consultants and brokers. The incumbent interprets client specific clinical data to assess clinical interventions that deliver clinical and financial results. They represent Clinical Strategy to maintain, improve and design reporting that meets the needs of the clients.

Requirements

• Bachelor's Degree in Nursing or a clinical related field
• 5 years in a clinical or managed care setting
• 3 years of analyzing clinical outcome data
• 3 years of Project Management
• Critical thinking skills
• Understanding of key clinical concepts
• Strong proficiency in Microsoft Office, Cognos, Analytics Navigator and other similar databases
• Effective problem solving and decision making skills
• Effective written and verbal communication skills
• Strong business acumen
• Conflict and crisis management skills

Nice To Haves

• Master's Degree in Business or a clinical related field
• 1 year designing outcome reporting and proficiency in reporting tools
• 1 year in a business or clinical environment with direct responsibility for applying technology
• Registered Nurse (RN)

Responsibilities

• Analyze client clinical data to determine trends and cost drivers that can be impacted by Highmark’s programs and services. Data set metrics include utilization and cost trends, prevalence and risk reporting, and aggregate population health management outcomes.
• Collaborate with Clinical Strategy Consultants, Health Management Strategy Consultants, Client Managers and other internal departments to prepare data analyses and deliverables that represent clinical management strategies and clinical capabilities to existing clients and potential clients.
• Develop and foster internal relationships across the organization and external vendor partners. Represent Clinical Strategy to maintain, improve and design reporting that demonstrate Highmark’s analytic insights, clinical capabilities, core/buy up product recommendations/outcomes and member engagement strategies.
• Research and stay current on health, wellness, productivity, risk and care management trends in the market place in order to share insights and best practices that should be illustrated in reporting/deliverables.
• Support Client Strategy Team and Client Managers for clinical related inquiries. Participate in internal workgroups as need, as subject matter experts.
• Responsible for identifying and completing a process improvement project at least annually in conjunction with Clinical Strategy leadership team. Assist by providing appropriate content and consultation to support the RFP/RFI process.
• Other duties as assigned or requested.

Benefits

• 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 any category protected by applicable federal, state, or local law.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level