HealthWorx Staff Post

https://www.disabledperson.com/jobs/12259923-program-innovation-development-program-director

Program Innovation & Development Program Director at CareFirst BlueCross BlueShield

Please apply before: 1/13/2017


PURPOSE: 

CareFirst is a leader in the health care industry serving approximately 3.2 million members. The Medical Affairs Division is responsible for all aspects of provider contracting, network management, pharmacy policy, quality of care and care management as well as the Primary Care Medical Home (PCMH) Field Operations and the Total Care and Cost Improvement (TCCI) program.

Reporting to the Chief Medical Officer, this individual will lead a team that will apply an analytic approach to identify new clinical opportunities and develop programs to pursue these opportunities. Examples of new opportunities may include new payment models for specialists, new TCCI programs and clinical/service partnerships, and partnerships with early stage companies to bring new technologies or services that can improve the health of CareFirst members to market.

PRINCIPAL ACCOUNTABILITIES:
Reporting to the Chief Medical Officer, the duties of this position include:

Identify new clinical opportunities; Lead the development of new programs

Independently drives the development of new clinical programs. This includes:

* Leading a data-driven approach to identify new clinical opportunities;
* Understanding the national landscape for clinical innovation and conducting market research to identify and evaluate potential vendors/partners; 
* Supporting the Medical Affairs leadership team in discussions/negotiations with new potential clinical partners; 
* Working closely and collaboratively with front-line operational partners in the Medical Affairs Division to stand-up new programs.
* Working with TCCI program managers to shape the ongoing development and evolution of programs after their inception 

Leads proactive problem solving including: problem identification, definition, analysis and recommendation as an individual producer and as a catalyst in small group settings.

Deliverables include: verbal reports and detailed point papers designed to monitor and encourage delivery against milestones contained in Divisional Plan.

Responsible for coordinating operations and leading special projects across all aspects of the medical affairs division and will operates as a shared resource for the Medical Affairs Division.

Provide expertise in the design principles of health care payment models, innovation in health care services and technology and will track developments in this field to ensure that CareFirst leads the industry in developing best practices.

Manage the development of new clinical partnerships

Works closely with the VP for Quality, Performance Measurement and Improvement, SVP/Chief Medical Officer and EVP for Medical Affairs to identify and develop key strategic clinical partners, including vendors, health care services and technology companies and specialist providers. Initial areas of focus will include new specialist payment and service delivery pilots, home based monitoring, and new technology and services that enable both CareFirst and its network providers to better manage members with multiple chronic diseases. This includes but is not limited to:

* Serving as a point of first contact and management for the creation of new, innovative partnerships;
* Convening and working with key stakeholders within CareFirst to analyze and vet potential new partners;
* Working with Medical Affairs senior leadership to develop programmatic material, terms and, eventually, service level agreements for new partnerships.

Form partnerships with early stage companies to bring new technologies or services that can improve the health of CareFirst members to market; Develop and manage HealthWorx portfolio of companies.

Helps to create and launch HealthWorx, a CareFirst incubator that will work with early stage companies to bring new technologies and services to market. This includes: 
* Maintaining a robust pipeline of potential portfolio companies through relationships with venture capital firms, industry and other seed-stage incubators; 
* Vetting and conducting research on potential partner companies; 
* Working with the Chief Medical Officer to select and prepare companies for presentation to CareFirst senior leadership; 
* Working with Medical Affairs leadership and colleagues in legal and finance to negotiate, draft and execute agreements with selected companies; 
* Managing the tracking the overall HealthWorx portfolio of companies; 
* Providing operational support to HealthWorx portfolio companies

QUALIFICATION REQUIREMENTS:

Required Education/Experience:
* An advanced degree in a health care related field (PhD, JD, MBA or MPH, with a concentration in health care or health economics) or equivalent work experience. Understanding of managed care concepts and operations. A minimum of 3-5 years experience with progressively increasing responsibility in health care environment, health insurance payer environment, or related industry.

Required Skills and Abilities:
* Proven project/program management skills, working collaboratively and effectively to drive complex deliverables in a matrixed environment.
* Proven experience with developing innovative health care delivery and payment models
* Demonstrated ability to effectively analyze and present data
* Excellent presentation skills
* Must be able to work independently with minimum oversight and demonstrate attention to detail, accuracy and quality awareness
* Proven analytical and problem solving skills
* Proven effective written and interpersonal communication skills, well organized, ability to multi-task and work independently, promote flexibility and teamwork
* Strong PC skills, Microsoft Word, Microsoft Outlook, Excel, database applications and fluency in statistical analysis (SAS, Stata, R or other statistical software)
* Strong understanding of the health care industry, with a specific focus on early stage health care companies and innovation in health care technology and services.
* Demonstrated leadership skills including the ability to: 1) train and motivate the performance of team members in a matrixed environment; 2) positively impact the performance of close colleagues as a trusted consultant.

Must be able to effectively work in a fast paced environment with frequently changing priorities, deadlines, and workloads that can be variable for long periods of time. Must be able to meet established deadlines and handle multiple customer service demands from internal and external customers, within set expectations for service excellence. Must be able to effectively communicate and provide positive customer service to every internal and external customer, including customers who may be demanding or otherwise challenging.

Preferred:
* Experience with vendor selection and management including RFPs, contract negotiation, service level agreements, etc.

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Department: SVP & Chief Medical Officer