Job Description
Job Desctiption:
Looking for an individual to join the Clinical Strategy team and provide a consultative approach to quantifying business opportunity. This role will be a mix of analytical responsibilities (70%), communication (10%), strategy (10%) ad hock requests (10%). This person will be responsible for providing analysis for projects surrounding utilization management, reduction of pre-cert requirements, and predictive models for procedure usage. The individual will be working with healthcare data including but not limited to, authorizations or claims data, pre-certification code and diagnosis codes. This person will be responsible for presenting data to executives in a clear, concise and data backed manor. The constituent will be working in an agile environment, participating in standing meetings, creating artifacts, and working cross functionally as needed. Accountable for evaluating internal and external concepts, with a focus on technology-enabled service delivery, competitive differentiation, process improvement and administrative efficiency.
Key Responsibilities:
* Responsible for assessing internal and external new business proposals and interfacing with vendors and/or matrixed staff as required
* Collaborates with internal subject matter experts to develop concept impact analyses and valuation forecasts
* Collaborates with Finance partners to develop initiative business cases, track project funding approvals and benefit realization to support efficient delivery and insights into ROI achievement
* Maintenance of new opportunity dashboard(s) as a reporting and value tracking mechanism for senior leadership review
* Business unit leader relationship management, including participation in governance bodies
* May be responsible for concurrent initiatives as team lead and/or team member, based on resource requirements
Required Skills & Experience
Must Haves:
Demonstrated relationship management skills at the senior level capacity to quickly build and maintain credible relationships at varying levels of the organization and with external entities simultaneously.
Bachelors Degree in business, finance, accouting or related field
Consultative approach and experince being involved in at least 3-4 projects at any given time
Ability to analyze data in excel, and transform it from Pivot tables to data visualizations in Tableau or Power BI to drive decisions
Strategic finance and investment planning
Demonstrated leadership with relevant initiatives:
Financial strategic planning
Utilization Management
Pre-Certification requirements
Healthcare industry experience
Experience with enterprise-wide and/or cross-functional large scale initiatives with high degree of complexity.
Nice to Have Skills & Experience
Health Care Payer industry background
Generative AI experience
Masters Degree
Benefit packages for this role will start on the 31st day of employment and include medical, dental, and vision insurance, as well as HSA, FSA, and DCFSA account options, and 401k retirement account access with employer matching. Employees in this role are also entitled to paid sick leave and/or other paid time off as provided by applicable law.