Company Statement
EmblemHealth is one of the nation’s largest not for profit health insurers, serving members across New York’s diverse communities with a full range of commercial and government-sponsored health plans for employers, individuals, and families. With a commitment to value-based care, EmblemHealth partners with top hospitals and doctors, including its own AdvantageCare Physicians, to deliver quality, affordable, convenient care. At over a dozen EmblemHealth Neighborhood Care locations, members and non-members alike have access to community-based health and wellness guidance and resources. For more information, visit emblemhealth.com.
If you’re an EmblemHealth employee, unlock your career potential by signing in at the top of this page. Access your employee profile to view internal job postings and explore new opportunities.
Clinical Strategy & Innovation Leader
Summary of Position
Translate clinical strategy into defined tactics, program priorities, timelines, and ensure alignment with enterprise growth strategy. Build and leverage enterprise relationships to provide innovative clinical solutions to complex problems. Lead a strategically oriented project portfolio, while monitoring internal and/or external dependencies. Ensure projects are properly funded and staffed, have/maintain executive sponsorship, and key stakeholders are continuously engaged and aware of projects status and critical issues. Uphold the enterprise’s compliance, code of ethics and business conduct.
Principal Accountabilities
- Oversee and support multiple, complex projects based on the Chief Medical Office strategy and priorities.
- Track and manage all project action items to timely resolution.
- Responsible for developing and deploying CMO Forensics Product for multiple areas/functions: Pharmacy, UM, Care Management, BH, Clinical Quality.
- Oversee the planning, implementation, and evaluation of the Chief Medical Office programs, ensuring they meet clinical standards and address community needs.
- Support department executive in executing clinical strategy, enhance organizational culture, team development and process improvement.
- Actively lead in project status meetings; may lead on project Steering Committees of mission critical projects.
- Responsible for launching New Products that support the profitability of the business.
- Responsible for developing and deploying Point Solution Command Center Portfolio.
- Work to improve the overall management of 3rd party point solutions engaged with the enterprise: manage - current 3rd party point solutions, including sourcing, evaluating, contracting and ROI monitoring.
- Establish and implement point solution management strategy (policies, standards, procedures, necessary technologies, etc.). Contribute to decision making regarding utilization of point solutions.
- Identify, track and monitor clinical trends across pharmacy, care management and utilization management.
- Propose and implement innovative solutions that addresses clinical trends across all LoB.
- Partner with external entities to develop patient recruitment model.
Qualifications
- Bachelors’ degree required; masters’ degree preferred
- PMI Certification - Project Management Professional (PMP) preferred
- 10 – 12+ years’ professional experience, preferably with healthcare organizations
- 3+ years’ experience managing large and highly complex projects
- Ability to synthesize data and turn it into actionable insights, identifying patterns and trends, using these insights to drive specific, practical actions
- Vendor management experience; understanding of and ability to evaluate, source and monitor vendors
- Ability to build and maintain relationships with staff up to and including leadership
- Excellent communication skills (verbal, written, presentation, interpersonal) with all types/levels of audiences
- Expert knowledge of Microsoft Office tools, (Excel, Word, PowerPoint, Teams, Outlook)
Security Disclosure
If you receive a job offer from EmblemHealth, the email will be from “HRTalentAcquisition” with the subject: “Offer of Employment for (job title) – Please respond online.” We will never ask you to join a Google Hangout, buy your own equipment, or pay to apply. We also do not use third-party email services like Yahoo or Gmail.
Pay Disclosure
At EmblemHealth, we prioritize transparency in our compensation practices. We provide a good faith estimate of the salary range for potential hires, which is based on key factors such as role responsibilities, candidate experience, education and training, internal equity, and market conditions. Please be aware that this estimate doesn’t account for geographic differences related to your work location. Typically, new hires may not start at the top of this range, as compensation is tailored to each individual's circumstances. For union positions, salaries will be determined according to the collective bargaining agreement. Join us at EmblemHealth, where your contributions are valued and supported by fair compensation.
EEOC Statement
We value the diverse backgrounds, perspectives, and experiences of our workforce. As an equal opportunity employer, we consider all qualified applicants for employment regardless of race, color, religion, sex, sexual orientation, gender identity, pregnancy, marital status, national origin, disability, veteran status, or any other protected characteristic protected by law.
Sponsorship Statement
At EmblemHealth, we are committed to building a diverse and talented workforce. However, we are unable to consider applicants who require, or are likely to require, either before or after hire, visa sponsorship for work authorization in the United States, including but not limited to H-1B, F-1 (STEM OPT), TN, or any other non-immigrant status. Some extremely rare exceptions may apply based on critical business needs.