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.

Plusses:

• Health Care Payer industry background
• Generative AI experience
• Masters Degree

Job Description:

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