Market Director

Highmark Health

About The Position

This job directs the overall strategy for Highmark's provider relationships within a designated market, operating in direct alignment with the market's overarching strategic plan set by the VP Market Executive. The incumbent is responsible for cultivating and deepening strategic partnerships with key provider organizations, ensuring their engagement supports Highmark's corporate objectives for quality, cost, and member experience as defined within the market's strategic framework. This role leads the market's provider engagement strategy, oversees the efforts of Provider Partner Consultants, and serves as a high-level liaison to achieve mutually beneficial outcomes and sustainable partnerships. The incumbent will build and nurture the overall relationship with strategic provider partners, aligning on strategy and partnership goals, and overseeing the partnership roadmap. They will engage with C-suite and upper level provider leadership and internal Highmark stakeholders to drive significant market-level initiatives and champion the provider perspective within the organization, all in support of the VP Market Executive's vision for the market's delivery system performance.

Requirements

7 years of experience in the health care/health insurance industry to include value-based care and provider relations/network management
Experience with data analytics and trending
Strong interpersonal organizational and analytical skills
Superior communication (written and oral), teamwork, organizational and leadership skills
Strong understanding of health care quality programs such as STARS, HEDIS
Understanding dynamics of matrix organization
Bachelor’s degree or relevant experience and/or education as determined by the company in lieu of bachelor's degree.

Nice To Haves

Experience working in provider or health system administrative or clinical role
Master's degree.

Responsibilities

Identify and cultivate relationships with providers in value-based arrangements outside of the Top 40 provider entities.
Establish key contacts in all critical areas of the identified provider entity/system.
Oversee administration of critical and timely communication to providers through ongoing personal contacts, site visits, regional communication sessions, meetings with professional organizations to communicate initiatives and changes.
In partnership with the Market Executive, conduct analysis and make data driven decisions to ensure we are getting appropriate returns on investments for initiatives, increasing quality, lowering cost, and increasing patient satisfaction.
Work with actuary and informatics teams to develop population health tools/reports, care alignment reports, and other resources that will produce value for Highmark, the provider partner, and the member.
Utilize data to make informed decisions, negotiation skills to achieve desired results, and project management skills to ensure successful execution of commitments.
Work collaboratively across the internal enterprise, establish networks to support provider engagement.
Promote efficient communications in close partnership with Provider Engagement including coordination of provider advisory groups, forums and events hosted by Highmark.
Identify, develop, and grow provider relationships through collaboration that will form the glide path for future transformation in care delivery and reimbursement models. This requires interfacing with various departments in the organization as well as vendor teams.
Other duties as assigned or requested.