Company :
Highmark HealthJob Description :
JOB SUMMARY
This role serves as a dedicated strategic partner to the Senior Director of Case Management Product, focusing specifically on the strategic alignment, growth, and optimization of both the Case Management program portfolio and the Case Management platform & capabilities portfolio. The incumbent will translate overarching enterprise strategy into actionable product and program strategies for Case Management, ensuring strong linkages between technical capabilities, operational execution, and business outcomes. This includes deep dives into market opportunities, leveraging internal expertise to inform strategic direction for our CM offerings, and identifying strategic pathways for innovation and efficiency within our clinical operations and supporting technology. A key responsibility will be to synthesize complex strategic insights, business cases, and portfolio roadmaps into compelling, executive-level presentations and communications that clearly articulate the value, strategic rationale, and desired outcomes for our Case Management initiatives.
This job supports the executive leadership of the Organization with a range of strategy activities essential to ensuring the Organization's goals. Provide analytical/strategic thinking and leadership support that enables project teams to isolate business issues, design and execute analytics for studying business issues (market research, scenario planning, forecasting, market share, profitability, etc.), develop technical content (competitive intelligence, market trend analysis), support development of formal recommendations to senior levels of organizational leadership, create documents (go-to-market or operational strategies, etc.) that inform critical strategic issues and decisions, support the planning, communication, and management of the enterprise strategy, and/or support the execution of enterprise strategic initiatives through a disciplined process and approach.
ESSENTIAL RESPONSIBILITIES
Work with business/market owners to identify key business issues, apply right analytical framework, develop solution and recommendations, represent findings to stakeholders, and own the outcome.
Manage major strategy projects comprised of internal and/or external consulting resources.
Provide periodic informal work guidance/direction to junior team members; provide performance input and recommendations to management for development/training plans. May have supervisory responsibilities on a project basis.
Develop analytical frameworks, approach, and methodology best practices to analyze strategy issues.
Consult with business owners to identify, clarify, and resolve complex issues critical to the success of the initiative.
Coordinate initiative impacts with other strategic initiatives to ensure alignment of the overall strategy.
Work on other Enterprise level strategy projects as needed.
Other duties as assigned or requested.
EDUCATION
Required
Bachelor's Degree in Business, or related field, or relevant experience and/or education as determined by the company in lieu of bachelor's degree.
Preferred
Master’s Degree in Business, or related field
EXPERIENCE
Required
7 years of experience in strategic planning or related work experience
2 years of consulting experience (external or internal) or equivalent combination of experience and advanced degree
Preferred
Experience in developing product or portfolio-level strategies, roadmaps, and business cases.
Proven experience in preparing and delivering executive-level presentations, strategic narratives, and white papers that drive decision-making.
Extensive knowledge of health insurance and/or provider operations
Experience in operational improvement, change management, capability roadmaps, and/or program management
Thorough knowledge of membership, rates, financial, economic, and competitive data
Significant experience working across teams and managing relationships in a matrixed environment
Experience working with health plans, physicians, and other providers
Support the planning, communication, and management of the enterprise strategy
Direct experience with Case Management, Care Management, or clinical operations.
Experience working closely with product management and/or engineering teams to define and prioritize strategic initiatives.
- Familiarity with technology trends and their application in healthcare, especially related to workflow automation, data analytics, and digital health within clinical programs.
- Demonstrated success in identifying strategic growth opportunities and designing initiatives to capture them, with a focus on value creation for both members and the organization.
SKILLS
Understanding of the health care industry trends and challenges
Demonstrated relationship, influencing, collaboration, and teamwork skills. Needs to be able to lead cross-functional, cross-business unit teams in complex projects and handle internal politics of change
Strong project leadership/management skills
Strong emotional intelligence, with servant leadership mindset
Focus on impacts to the customer of decisions rendered
Proactive in driving change and continuous improvement
Team management skills
Deep analytical skills, with the ability to structure and perform complex analytics
Demonstrated ability to synthesize complex information from diverse sources (e.g., market data, operational metrics, clinical outcomes, technical capabilities) into clear, concise strategic recommendations.
Exceptional storytelling and presentation skills, with a track record of developing and delivering impactful communications to senior executive audiences.
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
Rarely
Works primarily out-of-the office selling products/services (sales employees)
Never
Physical work site required
Yes
Lifting: up to 10 pounds
Constantly
Lifting: 10 to 25 pounds
Occasionally
Lifting: 25 to 50 pounds
Never
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 any category protected by applicable federal, state, or local law.
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