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Dir Clinical Employer Sppt
Buffalo, Rochester, Syracuse, Utica
This position leads the Clinical Employer Support team which represents Health Care and Network Management with our employer customers, assists in product development work with Marketing and provides sales support and direct client interface for existing and prospective employer groups. The Director develops the strategy as it relates to provision of market competitive programs, develops positioning, packaging, and the processes to explain the value of the Health Plan’s care management programs. Directly supports our key accounts with proactive Health and Wellness consulting. This position keeps Health Care and Network Management leadership engaged in client work and is apprised of market expectations and trends.
• Supports and coordinates development and delivery of competitive care health promotion programs and creates the management value proposition for meetings with key accounts, attends account meetings, engaging and briefing CMO’s as needed.
• Develops and oversees the execution of the care management programs strategy as it relates to the packaging and positioning of the care management programs. This includes collaboration with Finance and Sales for pricing and marketing, Contracting for vendor relationships and negotiations, and Sales and Health Care Affairs leadership for providing accurate and up to date information to the marketplace.
• Develops methods to apprise Care Management Leadership of market demands based on interactions with employers, consultants and brokers. Influences and collaborates with other Directors and Vice Presidents in development of new programs and innovations to ensure health plan remains competitively positioned.
• Represent care management programs to our provider constituency, including IPAs, assuring collaboration and input in program development and implementation.
• Supports Senior Management to attend key account client meetings and provide custom service as required from Care Management.
• Provides oversight to the Clinical Account Management and Health Promotion staff.
• Develop, direct, and evaluate the workflows, policies, and procedures for Clinical Account Management and Health Promotion functions to assure integration across the health and medical continuum.
• Interacts regularly with Sales leadership, develops processes to effectively and efficiently engage in the sales process in all five regions, including the national market. Provides regular program of training to sales staff. This includes maintaining a solid knowledge of Sales most important clients, and targeting custom interventions to ensure their needs are met.
• Collaborates with Marketing and Sales leadership to integrate effective and innovative care management program features into benefit plans, marketing campaigns and Sales’ discussions with employer groups, brokers and consultants.
• Director and staff will directly meet with employer groups on a regular basis to support Sales and renewals, represent care management program buy ups, and deliver value reporting.
• In collaboration with the Sales and Marketing training department, develops and oversees a robust Sales training program to provide them with the knowledge and skills to effectively represent the value of care management to our employer customers.
• Develops and oversees a robust and regular communication plan and process to keep Health Care and Network Management leadership and staff up to date about emerging market requirements.
• Develops and oversees employer level care management reporting to establish Health Plan as a consultant to employer groups by demonstrating a robust understanding of the Group’s needs based on their claims experience and connect these needs to Health Plan’s programs. Develops ability to demonstrate outcomes and value. Develops professional presentations and trains team to deliver reports to employer groups.
• Engages and directs subject matter experts in preparation and follow up to employer meetings. Develops process and tracking to ensure client deliverables are met timely and accurately.
• Engages periodically with brokers and consultants to educate them on Health Plan’s care management programs and establishes working relationships that provide feedback that will assist in strategy development.
• Develop and maintain partnerships with community human service organizations throughout the region.
• Oversees the implementation of custom care management employer buy ups for self funded accounts coordinating the implementation between multiple internal Health Plan departments.
• Manage the budget and contracted vendor relationships for health promotion and risk reduction programs and services.
• Consistently demonstrates high standards of integrity by supporting the Lifetime Healthcare Companies’ mission and values and adhering to the Corporate Code of Conduct.
• Maintains high regard for member privacy in accordance with the corporate privacy policies and procedures.
• Maintains knowledge of all relevant legislative and regulatory mandates and ensures that all activities are in compliance with these requirements.
• Conducts periodic staff meetings to include timely distribution and education related to departmental and Ethics/Compliance information.
• Regular and reliable attendance is expected and required.
• Performs other functions as assigned by management.
• Bachelors in nursing, health education, public health or related field; Masters preferred.
• Minimum of five years relevant program development and delivery experience.
• Experience with creating and implementing Wellness programs strongly preferred.
• Experience leading a team with various locations, stongly preferred.
• Must possess a thorough understanding of Health Plan and have demonstrated skills in working in a matrix management environment.
• Knowledge of statistics, measurement methods, and vendor contracting management.
• Must have excellent written and oral communication skills, with ability to communicate energy, enthusiasm, as well as credibility in clinical matters.
• Prior experience giving presentations and public speaking strongly preferred.
• Working knowledge of PowerPoint and Excel.
Must be able to transport, lift and set up displays with numerous supplies and materials. Must be able to transport and set up audio-visual equipment for programs and presentations.
Must be licensed and have transportation to drive to and from regions and community meetings across Excellus.
Routine office; internal and external meetings; outreach meetings and conferences in a variety of settings; must be able to frequently work beyond what is considered the normal work-day and adapt to changing needs on short notice.
In support of the Americans with Disabilities Act, this job description lists only those responsibilities and qualifications deemed essential to the position.
Equal Opportunity Employer
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