Home, Pennsylvania

**Company :**

Highmark Health

**Job Description :**

**General Overview:**

This job is responsible for work across the Curated Health Model, Customer Experience and Clinician Experience solution portfolios to support a broad scope of strategic activities. This “athlete” player drives and owns different potential roles on a given project, to include elements of problem-solving, strategy development, data analytics, communication, solution inventory and assessment, and rationalization of the existing portfolio and design to optimize our Living Health solutions. The incumbent will ensure viability of solutions through business model design, defining associated business processes, and developing operational plans, while considering economic factors. Working closely with Solution Portfolio Leaders, Design Strategists and stakeholders, incumbents will assess solutions to isolate business, customer and clinician issues, design and execute analytical processes, develop technical content (requirements and user stories), support development of formal recommendations, and create documents to outline the design of systems that are critical to solution activation. Solution design activities that the incumbent will drive include the business modeling, documentation, management and oversight of end to end workflow process analysis, assuring improved productivity and cost effectiveness, appropriate embedding of Key Performance Indicators, and controls for regulatory, risk, and compliance considerations.

**Essential Responsibilities:**

+ Support definition, scoping, and prioritization of efforts for solution strategy and analysis within workstreams. Provide and support periodic reporting to leadership on assigned project activities.

+ Drive and maintain strong working relationships across matrixed teams and stakeholder groups, continuing to promote and continually broaden the level of business knowledge and the impact of solutioning efforts.

+ Lead planning sessions with solution portfolio leaders, and clinician and business stakeholders to understand, document and design improvements to business models, processes, and systems to help prioritize and drive solution development.

+ Leverage a mix of frameworks and practices to deliver actionable insights and recommendations including: LEAN, Six Sigma,work simplification, organizational design, scenario planning, performance measurement, and process optimization.

+ Participate and apply methods in Human-Centered Design, along with core business analysis frameworks, to help identify impacts to people, process, and technology solutions that are required to achieve solution objectives and support business case development.

+ Identify root causes of problems and demonstrate the ability to development and make recommendations for solutions to mitigate root cause.

+ Develop documentation, presentations, and communications that detail findings, articulate strategies, provide justification and make the case for solution approaches and priorities.

+ Help develop standard solution strategy and analysis processes to use in leading various initiatives. Play a role in shaping the culture and skill set of the Solution Delivery Experience organization.

+ Other duties as assigned or requested.



+ Bachelor's Degree


+ 6 years of related and progressive experience in lieu of Bachelor's degree


+ None



+ 5 years in a Business Consulting, Business Strategist, Business Analyst or Business Process Analyst role or experience in a related operational area (e.g. claims, billing, care delivery, customer service, etc.)


+ 3 years in the Health Care Industry

+ Experience with I.T. Architecture.

+ Advanced skills utilizing Visio.

+ Strong Utilization Management background.

+ Business Intelligence software experience related to analytics tools.

+ Experience working with internal partners to build and develop business cases.



+ None


+ None


+ Strong Facilitation skills

+ Strong verbal and written communication skills

+ Ability to use statistical assessment to quantify opportunities and to achieve process optimization

+ Knowledge of the roles and deployment of change execution

+ Knowledge of Business Process Modeling concepts and components and their respective application

+ Strong understanding of Health Care specific domains

+ Ability to observe and provide constructive performance feedback

+ Knowledge and understanding of Lean Six Sigma Tools and Methodologies

+ Ability to develop strategic and analytical documentation, presentations and communications

**Referral Bonus:** Level 2

**Language (Other than English):**


**Travel Requirement:**

0% - 25%


**Position Type**


Teaches / trains others regularly


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


Works primarily out-of-the office selling products/services (sales employees)


Physical work site required


Lifting: up to 10 pounds


Lifting: 10 to 25 pounds


Lifting: 25 to 50 pounds


**_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.

EEO is The Law

Equal Opportunity Employer Minorities/Women/ProtectedVeterans/Disabled/Sexual Orientation/Gender Identity ( http://www1.eeoc.gov/employers/upload/eeoc\_self\_print\_poster.pdf )

We endeavor to make this site accessible to any and all users. If you would like to contact us regarding the accessibility of our website or need assistance completing the application process, please contact number below.

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

California Consumer Privacy Act Employees, Contractors, and Applicants Notice

Req ID: J184616

Home, Pennsylvania

Invest in yourself by becoming part of the Highmark Health enterprise! Build and grow your career with the tools and resources you need to be successful in our innovative and transformational environment. From new hire training to advanced education opportunities, career planning is a continuous journey that leads to your personal and professional growth and our success.

Whether your focus is nursing, information technology, actuarial, finance, marketing, sales, operations or one of our many other professions, our companies offer opportunities to develop and expand your career while making health care accessible, understandable and affordable for our millions of members, patients and customers.

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