Provider Partnership Consultant

Highmark Health; Whitpain Township (PA); Hybrid; USD 120,000 - 180,000; Full time

Job summary

Highmark Health seeks a leader to drive the design and market deployment of a portfolio of provider partnership offerings. You will coordinate with provider partner teams, market leaders, and external partners to craft services, analytics, and reimbursement models that enhance population health and care delivery.

This hybrid role covers SEPA and Delaware markets, requiring strategic oversight and strong collaboration.

Qualifications

• Bachelor’s degree in business or healthcare administration or related field, or equivalent experience.
• Master’s degree preferred in business or healthcare administration.
• Strong analytic background and ability to assess business processes and performance.
• Experience in market-facing roles and leading large strategic initiatives.

Responsibilities

• Lead design and deployment of provider partnership offerings across markets and provider networks.
• Coordinate with provider partner teams, market leaders, and external partners to design, deploy and evaluate offerings.
• Develop business case models, analyses, and recommendations for program launch and evolution.
• Own delivery outcomes and communicate strategy and program artifacts internally and externally.

Skills

Strategic thinking

Communication

Presentation skills

Problem solving

Education

Bachelor's Degree in Business Administration/Healthcare Administration or related field

Master’s Degree in Business Administration/Healthcare Administration or related field

Tools

MS Office

PowerPoint

Excel

Job description

Company : Highmark Inc. Job Description : JOB SUMMARY

JOB SUMMARY

This job will lead the design and ongoing market deployment of a portfolio of provider partnership offerings in coordination with the provider partner teams and market leaders. The partner provider program will be delivered to partner provider organizations including ancillary provider networks, independent physician organizations and health systems/integrated delivery networks. The program offerings include value added services and capabilities for providers such as regional medical insurance products, customized analytics and reporting packages, elevated support and servicing models, access to external vendor delivered solutions and services, population health capabilities and resources, and alternative reimbursement models, joint ventures and other novel offerings. This job interacts with matrixed areas of the organization, the market facing provider teams and external provider partners to design and deploy offerings involving both internal and external constituents (e.g. vendors, IDN, provider, regulators) as necessary to ensure successful delivery of new offerings and the overall program. Responsible for providing leadership and direction to matrix staff across the enterprise including business and technical teams for the purpose of program offering design and deployment. The incumbent will function as a liaison with the partner provider team and internal areas to support and manage the execution of the program for the organization. This is a hybrid based role in SEPA - Will be supporting the SEPA and DE market.

ESSENTIAL RESPONSIBILITIES

Manage and lead major projects and teams comprised of internal or external resources. This may involve providing periodic informal work guidance/direction to other team members; providing performance input and recommendations to management for development/training plans. Work with business/market owners, key executives, partner providers, external experts and industry contacts through all stages of the initial and ongoing offering development lifecycle to identify and design a strategy for specific offerings in the program. This includes evaluating the benefits and value of potential offerings for the program. Lead design and development sessions with matrixed internal teams and external provider organizations, gather essential data, execute the required analyses, develop business case models, identify issues or problems, develop proposed solutions/ approaches and develop formal recommendations to senior levels of the Organization leadership to support the provider partnership offering program launch and ongoing evolution. The incumbent must own the outcome of the offering element and ensure expert delivery. Design and own the development and creation deliverable artifacts to communicate internally and externally the organization's partner provider strategy and program. Apply a broad knowledge of concepts and principles to develop analytical frameworks, approach and methodology best practices to analyze complex strategy issues, often applying ingenuity and originality to develop unique solutions. Consult with business owners to identify, clarify, and resolve complex issues critical to the success of the offering initiatives. Other duties as assigned or requested.

EDUCATION

Required Bachelor's Degree in Business Administration, Healthcare Administration or other related field or relevant experience and/or education as determined by the company in lieu of bachelor's degree. Preferred Master’s Degree in Business Administration, Healthcare Administration or other related field.

EXPERIENCE

Required 5 years of post-grad experience in any or combination of the following: strategic planning, consulting, project management or in leadership role Experience in leading large scale strategic initiatives and/or process improvement initiatives to address business challenges Strong analytic background (ability to assess business processes; product performance; etc.) Preferred 3 years' management consulting experience in health sector (payer, provider, or life sciences) Extensive knowledge of healthcare industry, Insurance operations and financing, clinical delivery, and/or ancillary products Experience in a market facing role, interacting with clients and or external decision makers Experience in program management and development, operational improvement Applied experience in provider, IDN or clinical delivery.

SKILLS

Broad application of principles, theories, and concepts in strategic thinking, plus working knowledge of other related fields. Strong PC application skills (MS Office including PowerPoint and Excel). Must be extremely proficient in developing PowerPoint collateral to convey ideas and concepts effectively. Knowledge of healthcare industry trends and challenges. Strong critical thinking skills. Good communication and presentation skills. Language (Other than English): None.

Travel Requirement

25% - 50%.

PHYSICAL, MENTAL DEMANDS and WORKING CONDITIONS

Position Type Office-based. Teaches / trains others regularly. Occasionally Travel regularly from the office to various work sites or from site-to-site. Occasionally Works primarily out-of-the office selling products/services (sales employees). Never Physical work site required. Yes. Lifting: up to 10 pounds. Constantly Lifting: 10 to 25 pounds. Occasionally Lifting: 25 to 50 pounds. Rarely.

Disclaimer

The job description has been designed to indicate the general nature and essential duties and responsibilities of work performed by employees within this job title. It may not contain a comprehensive inventory of all duties, responsibilities, and qualifications required of employees to do this job.

Compliance Requirement

This job adheres to the ethical and legal standards and behavioral expectations as set forth in the code of business conduct and company policies. As a component of job responsibilities, employees may have access to covered information, cardholder data, or other confidential customer information that must be protected at all times. In connection with this, all employees must comply with both the Health Insurance Portability Accountability Act of 1996 (HIPAA) as described in the Notice of Privacy Practices and Privacy Policies and Procedures as well as all data security guidelines established within the Company’s Handbook of Privacy Policies and Practices and Information Security Policy. Furthermore, it is every employee’s responsibility to comply with the company’s Code of Business Conduct. This includes but is not limited to adherence to applicable federal and state laws, rules, and regulations as well as company policies and training requirements. Highmark Health and its affiliates prohibit discrimination against qualified individuals based on their status as protected veterans or individuals with disabilities and prohibit discrimination against all individuals based on any category protected by applicable federal, state, or local law. California Consumer Privacy Act Employees, Contractors, and Applicants Notice.

About Highmark Health

Highmark Health is a national, blended health organization that includes one of America’s largest Blue Cross Blue Shield insurers and a growing regional hospital and physician network. Based in Pittsburgh, Pa., Highmark Health’s 35,000 employees serve millions of customers nationwide through the nonprofit organization’s affiliated businesses, which include Highmark Inc., Allegheny Health Network, HM Insurance Group, United Concordia Dental, HM Health Solutions and HM Home & Community Services. Highmark Health’s businesses proudly serve a broad spectrum of health-related needs including health insurance, health care delivery, population health management, dental solutions, reinsurance solutions, and innovative, technology solutions.