Company :Highmark Inc.Job Description : 

JOB SUMMARY

This job helps to develop and leads the execution of the market strategy for Federal Markets. Determines the Organization's relative position within markets. Ensures product, network, and market strategies support profitable growth and retention. Drives execution across the organization. Leverages market intelligence and multi-dimensional profitability data to establish and execute a market strategy for Senior Markets across all geographies in order to grow Federal Markets membership and meet Health Plan contribution margin goals. Collaborates with Living Health, Product, Provider Network & Reimbursement, Actuarial, and Analytic functions to set parameters for measuring the success of strategies and tactics. Leads the development and use of multi-dimensional analytics used to inform the overall market strategy/positioning. Leveraging an analytical base of member, product/network and channel profitability, this job contributes to the overall market approach and positioning. Close collaboration with key functional matrix partners is critical for on-going success, including Product, Enterprise Analytics, and Actuarial teams. This job will periodically involve external-facing responsibilities including with local and/or national media.

ESSENTIAL RESPONSIBILITIES

Perform management responsibilities to include, but are not limited to: involved in hiring and termination decisions, coaching and development, rewards and recognition, performance management and staff productivity.  Plan, organize, staff, direct and control the day-to-day operations of the department; develop and implement policies and programs as necessary; may have budgetary responsibility and authority.Drive advanced multi-dimensional business and market analytics. Utilize analytics to determine profitability in member, product, channel, and geographic market segments. Use this analysis to determine adjustments that could be made in product, network, experience, etc. to improve position.Utilize analytics to guide the market strategy to the optimal intersection of member, product/network (including metal tiers and other plan designs), rate and channel. Consider and incorporate competitor information, financial performance, and functional strategies of matrixed partners.Monitor macro-market developments (e.g., competitors, regulators, economy, demographics) and ensure appropriate inclusion in all aspects of market strategy. Understand implications of these developments and take actions accordingly.Other duties as assigned

EDUCATION

Required

Bachelor's Degree in Business Administration/Management, Economics, or Engineering

Substitutions

None

Preferred

Master's Degree in Business Administration/Management, Economics, or Engineering

EXPERIENCE

Required

7 years in a Consulting role OR in the Healthcare Industry

To include

5 years in a management or leadership role

Preferred

None

LICENSES AND CERTIFICATIONS

Required

None

Preferred

None

SKILLS

AnalyticsBusiness ConsultingCommunication SkillsCollaborationMedicare Advantage or ACA Individual MarketProblem Solving & Decision Making

Language (Other than English)

None 

Travel Required

0%  - 25%

PHYSICAL, MENTAL DEMANDS and WORKING CONDITIONS

Position Type

Office-Based

Teaches / trains others regularly

Frequently

Travel regularly from the office to various work sites or from site-to-site

Rarely

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 their race, color, religion, sex, national origin, sexual orientation/gender identity or any other category protected by applicable federal, state or local law. Highmark Health and its affiliates take affirmative action to employ and advance in employment individuals without regard to race, color, religion, sex, national origin, sexual orientation/gender identity, protected veteran status or disability.

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 their race, color, age, religion, sex, national origin, sexual orientation/gender identity or any other category protected by applicable federal, state or local law. Highmark Health and its affiliates take affirmative action to employ and advance in employment individuals without regard to race, color, age, religion, sex, national origin, sexual orientation/gender identity, protected veteran status or disability. 

EEO is The Law

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For accommodation requests, please contact HR Services Online at HRServices@highmarkhealth.org

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