UPMC is actively seeking a full time Senior Director, Population Health! We are looking for a thought leader with a strong understanding of human capital. This individual should have extensive (ten plus years) experience working in management with history of working on benefit design/population health for employer populations, business development, or design strategy. This role will be located in downtown Pittsburgh, Pa.
UPMC Health Plan, headquartered in Pittsburgh, Pennsylvania, is among the nation's fastest-growing health plans. It is owned by the University of Pittsburgh Medical Center (UPMC), a world-renowned health care provider. As part of an integrated health care delivery system, UPMC Health Plan is committed to providing its members better health, more financial security, and the peace of mind they deserve. UPMC Health Plan partners with UPMC and community network providers to produce a combination of knowledge and expertise that provides the highest quality care at the most affordable price. The UPMC Insurance Services Division — which includes UPMC Health Plan, WorkPartners, UPMC for Life, UPMC for You, UPMC for Kids, and Community Care Behavioral Health — offers a full range of group health insurance, Medicare, Special Needs, CHIP, Medical Assistance, behavioral health, employee assistance, and workers' compensation products and services to more than 3.4 million members. Our local provider network includes UPMC as well as community providers, totaling more than 140 hospitals and more than 23,300 physicians throughout Pennsylvania and parts of Ohio, West Virginia, and Maryland.
Under the general direction of the Vice President of WorkPartners, the Sr. Director of Population Health will define and develop overall program objectives, scope and work plan and reviews. Recognize and anticipate scope and other project issues and communicate to internal client and project team as well as take appropriate measures. This position is to provide the thought leadership that guides a team of population health professionals and influences the tactics and strategies that are undertaken to positively impact the population health measures within WorkPartners employer clients. This position will review population trends and recommend new approaches for WorkPartners' clients. Dynamically leads presentations/work sessions to positively influence decisions and perceptions. The Sr. Director of Population Health will be responsible for influencing business strategy, product development, technology, human behavior, and design to develop interventions for health care products and business models that create value for employer populations. This position will be responsible for providing the thought leadership that aids in leading the design, implementation, and execution the Division-wide Population Health Management (PHM) strategy targeted at employers and for leveraging clinical programs, technologies and for collecting & integrating data to track, engage, monitor & support UPMC and the Health Plan and WorkPartners member population. The successful candidate will strongly influence the direction and strategy of the following areas of responsibility: development of programs and services for behavior change and engagement; integrating behavioral science and behavioral economics into policy, benefit design, operations, and interventions; assessing current programming capacity to manage the health of all members with a specific focus on high-risk, high-cost segments; utilizing benefit designs to support stakeholder engagement & widespread behavior change; reviewing trend and outcome reports of various functions at WorkPartners; and continuously modifying the programs as outcomes dictate to achieve optimal engagement for all UPMC Insurance Services Division's line(s) of business. This position will collaborate with a myriad of business owners and subject matter experts across the enterprise to energize the product/program design concepts to develop integrate and launch new programs/products. This position also provides leadership to positively influence decisions and perceptions to support and guide motivated and talented enterprise teams.
Anticipate key business issues, leverages solutions from dependent and related projects and generates new perspectives, frameworks or innovations that enable problem resolution. Define and develop overall program development and work collaboratively across the Insurance Services Division to optimize the performance of employer-based population health management programs. Maximize member engagement across the full risk spectrum; identify the need for new clinical interventions or enhancements to existing interventions; and achieve targeted population outcome goals and/or recommend that poorly designed programs which fail to yield meaningful or scalable results be discontinued.
Design programs that contribute to successful member engagement based on an expansion of the existing knowledge base; focuses on outcomes of economic interest; evidence-based interventions; supported by implementation plans that specify who, what, when, and how inclusive of timelines and milestones coupled with rigorous data collection, ongoing evaluation and reporting metrics. Analyze various data sources including but not limited to medical, leave and others to identify population trends and recommend solutions. Support the development and enhancement of risk stratification geographically, health/risk status, resource utilization.
Develop business expansion opportunities that focus on the unique strengths of UPMC, both regionally and nationally. Demonstrate health plan's philosophy and values and ensure that philosophy and mission drive the day-to-day operating environment.
Effectively creates collaborative environment with all UPMC Health Plan and WorkPartners disciplines to optimize delivery of products and services. maximize program value through the integration of EAP, Health Promotions, Health Coaching, (Physical Health and Behavior Health Disease and Case Management) Absence Management, Workers Compensation and other WorkPartners products and services.
Establish appropriate client relationship across all of UPMC to advance Population Health Strategy Establishes and leverages internal and external relationships with third party vendors, service providers, sales, marketing, business development and account management representatives; focusing all resources on high quality, integrated services delivery to clients
Guide and provide direction to multiple teams responsible for the management of innovative solutions and products leading to a competitive and advantage and improved customer satisfaction. Maintain up-to-date information on latest population health strategies across all services.
Institutionalize the vision; create the focus, ownership, and commitment to achieve it. Ensure that direct reports are engaged in activities based on organizational need and their technical skills and capabilities. Ensure internal resources and practices stimulate rather than inhibit highly effective and responsive performance. Provide resources to encourage fiscally sound activities that encourage the care, education, and dignity of the underserved. Provide leadership direction, including agenda preparation/monitoring and facilitation as needed, for multiple meetings, work groups and health plan committees.
Monitor existing program/service performance for all Health and Productivity service rendered to UPMC for appropriateness and effectiveness. Serve as key consultative lead for plan design and Health and Productivity Solutions provided to UPMC collaborating with internal experts and business leads.
Use results of analysis to identify subsets of the population requiring additional care management and/or targeted intervention(s). Develop strategies/programs in coordination with Product/Business leaders and/or Account Managers and key constituents across the Insurance Service Division, to effectively manage the health of employer populations and further differentiate our existing product suite.
Work with Health Plan and WorkPartners leadership to develop/implement consultative services for UPMC specifically regarding integrated strategies across all benefit lines. This can include: HR benefits, analytics, employee engagement, policies, technology and reporting. Manage a large number of responsibilities in the face of competing priorities.
Bachelors degree in Business, health care, management, or related field; Masters degree required (extensive related experience will be considered).
Minimum of 10 years of experience in management with history of working on benefit design/population health for employer populations, business development, or design strategy.
10 years experience in health care insurance or health care industry required.
Excellent computer skills required, including Access, Excel, Microsoft Project, and other pertinent computer software packages.
Strong management, problem solving, organizational, and communication skills (oral and written) are required.
Demonstrated expertise combining data analytics with qualitative customer research to create actionable insights.
Ability to collaborate with internal and external partners at all levels to create consensus, resolve project issues, and produce deliverables or exceptional quality.
Demonstrated track record of success in both strategic and operational roles in high performance, entrepreneurial organizations.
Strong knowledge and understanding of Disability and Absence Management strongly preferred.
Strong understanding of current and emerging technologies and consumer trends.
Strong working knowledge of the disease/chronic care management, health/wellness and or disability insurance industry.
Excellent written and oral communication skills.
Understand interdependencies of clinical, quality, business, marketing, operations, and technologies
Internal Number: 730282
About UPMC Health Plan
UPMC Health Plan, headquartered in Pittsburgh, Pa., is among the nation's fastest-growing health plans. It is owned by UPMC, a world-renowned health care provider. As part of an integrated health care delivery system, UPMC Health Plan is committed to providing its members better health, more financial security, and the peace of mind they deserve. UPMC Health Plan partners with UPMC and community network providers to produce a combination of knowledge and expertise that provides the highest quality care at the most affordable price. The UPMC Insurance Services Division — which includes UPMC Health Plan, UPMC WorkPartners, LifeSolutions, UPMC for Life, UPMC for You, UPMC for Kids, Askesis, and Community Care Behavioral Health — offers a full range of group health insurance, Medicare, Special Needs, CHIP, Medical Assistance, behavioral health, employee assistance, and workers' compensation products and services to over 3.2 million members. Our local provider network includes UPMC as well as community providers, totaling more than 130 hospitals and more than 20,000 physicians throughout Pennsylvania and parts of Ohio, West Virginia, and Maryland.