Clinical Strategy Consultant - Western PA/Erie

About the role

This job supports the acquisition of new accounts and retention of existing accounts in the Western PA/Erie location by working directly with client managers within national and regional markets. The incumbent is primarily accountable for the delivery of clinical analysis and strategies for Highmark customers, including healthcare consultants and brokers.

Responsibilities

• Perform as the clinical subject matter expert for clinical, quality, care, utilization, high-cost claim and population health management as part of the clinical presentations with external clients, brokers/producers and new to blue prospects.
• Develop strategy to support acquisition and renewal of membership; prepare for and provide clinical perspective on clinically-related discussions as needed; provide clinical and operational insights back to internal stakeholders and accounts after customer discussions.
• Participate in ad-hoc and annual clinical review meetings as needed to provide clinical, health and wellness perspective; provides broad clinical insights back to internal stakeholders and accounts after customer discussion.
• Keep pace with fast-changing environment, client cultures and trends to better support behavior change by increasing senior level support, improving value proposition with a goal of focused interventions, creative strategies and execution of all core clinical principles and programs.
• Collaborate with Clinical Strategy Analysts to create a message and deliver relevant metrics and clinical reports as well as quarterly and annual outcomes and trends for all clinical strategies for all current and emerging care models.
• Research and stay current on health, wellness, productivity, risk and care management trends in the marketplace to share insights and best practices in sales discussions; attend conferences and contribute to publications as needed to support the clients, consultants, partners and centers of excellence function.
• Coordinate all post sale and ongoing aspects of clinical product implementation and outcomes with senior level executives at the client level, external vendors and brokers. Track, communicate and implement best practices and industry specific successes and challenges for all markets.
• Primary client contact for clinical related issues/questions. Participate in internal groups as needed, as a subject matter expert. Assist by providing appropriate content and consultation to support the RFP / RFI process.
• Other duties as assigned or requested.

Requirements

• Required: Bachelor's Degree in Nursing, Pharmacy, Physician Assistant or a clinical field
• Preferred: Master's Degree in Business or a clinical field
• Required: 5 years in a Clinical or Managed care setting
• Preferred: 3 years of Client Sales Support
• Preferred: 3 years of external client facing

Qualifications

• Required: Current State RN licensure OR Current multi-state licensure through the enhanced Nurse Licensure Compact (eNLC).
• Preferred: Physician Assistant License
• Preferred: Pharmacist (PharmD)

Skills

• Critical thinking skills
• Understanding of key clinical concepts
• Effective problem solving and decision-making skills
• Excellent interpersonal, presentation, communication and listening skills
• Strong business acumen
• Demonstrated effective presentation delivery
• Conflict and crisis management skills

Benefits

Not specified

Pay

Not specified

Schedule

Not specified