Company Statement

For the last 80 years, EmblemHealth has been taking care of New York’s heart and soul, its people. Today, health care is more complex than ever. That’s why we’re at the forefront of change. We work alongside our customers to offer access to high-quality, affordable care, help navigate the health care experience, and make good health achievable; because everyone deserves to be taken care of. We deliver on our mission every day by living our values with our colleagues, members, clients and partners. It begins with caring and respecting all those we work with. We believe a culture of diversity and inclusion is vital to serve our unique and diverse customers. We seek for continues improvement and innovation and believe being agile and nimble is our advantage. We bring a strong sense of partnership to every relationship – internally and externally. The EmblemHealth family of companies offers competitive health, welfare, and retirement benefits as well as incentive pay plans and more.

AVP, Clinical Strategy

🔍 New York, New York

New

📁: Medical Operations

💼: EmblemHealth

📅   : 3 days ago Post Date

Summary of Position

Lead and drive process improvement initiatives in the Clinical Management & Medical Affairs and Population Health & Strategy departments to optimize the internal organization processes and infrastructure of our medical teams. Ensure appropriate quality programs and measures tracking and reporting of internal stakeholders. Identify areas for improvement, implement innovative solutions, and optimize processes to enhance efficiency, quality, and
cost-effectiveness which drive better health outcomes. Recommend and influence clinical, quality, and strategic programs including scope, complexity, and outcomes. Collaborate with cross-functional teams, analyze data, and develop strategies to streamline operations and drive continuous
improvement in medical management processes.

Principal Accountabilities

Ensure the business requirements of the Clinical Management & Medical Affairs and Population Health & Strategy departments are represented in cross functional governance forums to impact the lifecycle and enhancement of those solutions.
Formulate strategies and protocols to prevent/address potential challenges, and to streamline Medical Affairs.
Evaluate existing business processes; create documentation outlining process improvements; manage improvement teams and implementation processes; update department procedures and policies.
Create processes and integrate voice of the customer insights into cross-functional action plans.
Direct root cause analysis and work with all channels to identify and implement business process improvements that will prevent recurrence of issues; develop and manage the implementation of major transformation programs.
Define goals and key performance indicators for each member of the team and ensure effective implementation of the organization’s performance management process.
Develop talent within the team by providing guidance and coaching to achieve the defined goals.
Participate in development/oversee implementation of strategy aligned with the vision and mission of the plan.
Provide subject matter expertise for the assigned projects and provide leadership on all related areas to facilitate the achievement of success.
Lead key transformation projects, e.g., rethinking/redesigning of key customer processes, fixing priority customer pain points highlighted through customer feedback, or other key transformation initiatives.
Manage the full life cycle of project management including planning, execution, and handovers.
Lead the Transformation projects where needed based on assigned projects.
Lead the management of change through continuous improvement of functional systems, processes and practices, considering enterprise standards and changes in the business environment which demand proactive action plans.
Proactively identify and provide solutions for any strategic delivery risks and issues.
Articulate and strategize transformation initiatives into an actionable roadmap across Enterprise Businesses highlighted through customer feedback, or other key transformation initiatives.
Deliver high quality output in a timely manner by checking the progress of the projects against timelines and output against the quality parameters set by the Department.
Ensure quality delivery by vendor(s) in accordance with the plan(s) service level agreements.
Maintain industry level knowledge of trends, practices, digital design software, etc.

Education, Training, Licenses, Certifications

Bachelor’s degree; graduate degree preferred
PMI certification or Six Sigma training/certification preferred

Relevant Work Experience, Knowledge, Skills, and Abilities

10 – 12+ years of relevant, professional work experience (Required)
8 – 10+ years of experience in the healthcare insurance industry (Required)
Excellent understanding of Medical Affairs operations and business needs (Required)
Experience with project management, including planning, execution, and monitoring of projects (Required)
Strong communication and interpersonal skills to collaborate effectively with cross-functional teams and stakeholders, (including verbal, written and presentation communication) (Required)
Strong ability to drive collaboration and foster highly productive, functional relationships (Required)
Demonstrated agility and ability to drive program completion in expedited timelines (Required)
Excellent analytical and problem-solving skills, with the ability to interpret data and make data-driven decisions (Required)
Proven experience in leading process improvement initiatives and driving change within a healthcare organization (Required)
Ability to adapt to a fast-paced and evolving healthcare environment (Required)

Security Disclosure

If you are offered a job from one of the EmblemHealth family of companies that includes ConnectiCare, AdvantageCare Physicians, and WellSpark, the offer confirmation email will come from “HRTalentAcquisition” with the subject line: “Offer of Employment for (job title)” – Please respond online”.

We never ask you to join a Google Hangout, request you to purchase your own equipment or pay to apply. We do not send email from a third-party email service such as Yahoo or Gmail.

Pay Disclosure

A good faith estimate of the compensation range for individuals hired to work for the EmblemHealth Family of Companies is provided. This compensation range is specific and considers factors such as (but not limited to) the scope and responsibilities of the position, the candidate’s work experience, education/training, internal peer equity, and market and business considerations. The disclosed range estimate has not been adjusted for the applicable geographic differential associated with the location at which the work is being performed. It is not typical for an individual to be hired at or near the top of the range, as compensation decisions depend on each case’s facts and circumstances. Union roles covered by a collective bargaining agreement will compensate in accordance with the union contract.

EEOC Statement

We are committed to leveraging the diverse backgrounds, perspectives, and experiences of our workforce to create opportunities for our people and our business. We are an equal opportunity/affirmative action employer, and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex/gender, sexual orientation, gender identity or expression, pregnancy or related condition, marital status, national origin, disability, protected veteran status or any other characteristic protected by law.

Sponsorship Statement

Depending on factors such as business unit requirements, the nature of the position, cost and applicable laws and regulations, EmblemHealth may provide work visa sponsorship for certain positions.