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Resp & Qualifications

PURPOSE:

The Director, Innovation & Strategy is responsible for the implementation of care management, communication, analytics, reporting, IT, quality, regulatory and compliance workstreams for a network of health care providers, multiple networks or a large, multi-site health care delivery system. The plans the incumbent executes and develops are designed to shift from a fee-for-service to a value-based payment structure promoting clinical engagement and alignment while driving equitable access by better matching demand for services with supply.

_We are looking for an experienced people leader in the greater Baltimore/Washington metropolitan area who is willing and able to work in a hybrid model. The incumbent will be expected to work a portion of their week from home and at least two days a week at a CareFirst location based on business needs and work activities/deliverables that week._

ESSENTIAL FUNCTIONS:

+ Provides leadership in collaboration with CareFirst market segment leaders and/or Health System dyad leaders to develop, implement and evaluate all programs under Partnership arrangement including patient care programs, adequate networks, competitive networks, practice models and capital projects. Responsible for the identification and implementation of the business objectives focused on value-based program performance, with a focus on financial and clinical outcomes, capital requirements, resource allocation including space and personnel management.

+ Creates and monitors infrastructure, systems, processes and standards to achieve desired outcomes of Partnership in collaboration with CareFirst stakeholders and/or health system medical directors, leadership, department chairs and medical staff at both CareFirst and the Health System.

+ Organizes, leads, balances and executes strategies and supporting tactics of the Joint Operating Committee with CareFirst Market Segment Leaders and/or health system leadership. Works with service lines and related hospital and clinical, operational and departmental leaders at the Health System as well as legal, financial, contracting, and actuarial teams at CareFirst to collaboratively coordinate and implement efforts of the Partnership. Works with health system leadership to create programs that will drive growth and enhance business performance in key market segments.

+ Responsible for management and oversight of relationship with any additional consultants/vendors CareFirst may contract with for analysis on work executed in key relationships; direction and vision for policy and quality standards for all departmental work; inventory trends and impacts; tactical planning, implementation, monitoring and reporting; and ad hoc executive management reporting.

+ Oversees the strategic and the day-to-day activities of the Department, including directing, coaching, and guiding associates in order to implement departmental, divisional, and organizational mission/goals. Recruits, retains and develops a high performing team. Evaluates performance of each team member, generates development plans and sets goals within the context of the corporate policies and procedures. Develops annual goals, and prepares, monitors, and analyzes variances of departmental budgets in order to control and appropriately allocate resources.

QUALIFICATIONS:

**Education Level:** Bachelor's Degree, Business, Healthcare, Finance or related field or equivalent experience, with strong financial background OR in lieu of a Bachelor's degree, an additional 4 years of relevant work experience is required in addition to the required work experience.

**Experience:** 8 years health care insurance industry with specific experience in health system operation, value-based programs, and service line management. 3 years supervisory experience or demonstrated progressive leadership experience

Preferred Qualifications

+ Analytical skills principles as evidenced by CPA or MBA highly desirable.

Knowledge, Skills and Abilities (KSAs)

+ Knowledge of CareFirst's or other payer's provider networks and contracts.

+ Proficient in computer software applications.

+ Deep knowledge of health system organizational structures and operating processes.

+ Ability to deliver on patient experience, provider and employee experience, quality and financial results for areas of accountability.

+ Effective communication skills; verbal, written and presentation.

+ Demonstrated ability to be flexible, lead change, remain current with healthcare environment changes and translate those changes into operational plans to discern and interpret the potential impact on assigned departments/community(s).

+ Demonstrated experience in developing successful working relationships at all levels of the organization.

+ The ability to maintain and build relationships within the community and the company at different organizational levels.

+ Self-directed with the ability to work independently and make decisions in a changing environment.

+ Demonstrated successful planning and organizational skills in developing and implementing strategic and tactical plans.

+ Ability to mentor and coach associates to accomplish goals, provide objective evaluation of associate performance, and implement strategies to improve individual and team-based performance as needed.

+ Must be able to meet established deadlines and handle multiple customer service demands from internal and external customers, within set expectations for service excellence. Must be able to effectively communicate and provide positive customer service to every internal and external customer, including customers who may be demanding or otherwise challenging. **Salary Range** : $157,200 - $291,803

Salary Range Disclaimer

The disclosed range estimate has not been adjusted for the applicable geographic differential associated with the location at which the work is being performed. This compensation range is specific and considers factors such as (but not limited to) the scope and responsibilites of the position, the candidate's work experience, education/training, internal peer equity, and market and business consideration. It is not typical for an individual to be hired at the top of the range, as compensation decisions depend on each case's facts and circumstances, including but not limited to experience, internal equity, and location. In addition to your compensation, CareFirst offers a comprehensive benefits package, various incentive programs/plans, and 401k contribution programs/plans (all benefits/incentives are subject to eligibility requirements).

Department

MedStar Joint Management Team

Equal Employment Opportunity

CareFirst BlueCross BlueShield is an Equal Opportunity (EEO) employer. It is the policy of the Company to provide equal employment opportunities to all qualified applicants without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, age, protected veteran or disabled status, or genetic information.

Where To Apply

Please visit our website to apply: www.carefirst.com/careers

Federal Disc/Physical Demand

Note: The incumbent is required to immediately disclose any debarment, exclusion, or other event that makes him/her ineligible to perform work directly or indirectly on health care programs.

PHYSICAL DEMANDS:

The associate is primarily seated while performing the duties of the position. Occasional walking or standing is required. The hands are regularly used to write, type, key and handle or feel small controls and objects. The associate must frequently talk and hear. Weights up to 25 pounds are occasionally lifted.

Sponsorship in US

Must be eligible to work in the U.S. without Sponsorship.

\#LI-NH2

REQNUMBER: 21232