Director – Cost of Care

Director – Cost of Care

Requirements

• Bachelor’s degree in business, health care administration or related field, or equivalent experience.
• Minimum of 7 years of experience that reflects expertise, success, and demonstrated experience leading complex, successful cross-functional strategic programs, including research, concept, and optimization development.
• Experience implementing transformation strategies, change leadership and a demonstrated understanding and application of how to balance the business, financial risk and superior service to a member base.
• Minimum of 5 years of demonstrated broad-based health care and/or pharmacy background.
• Strong knowledge of health regulatory and accreditation standards.
• Excellent abilities in leveraging health care and/or pharmacy insurance industry knowledge, which may include product design/management, delivery systems and managed care concepts, along with technical expertise, and proven success building and sustaining relationships based on competence, trust, and mutual respect.
• Strong technical abilities needed to establish and measure results through sound metrics; experience with measurement tools and analysis including the use of quality measurement tools and efficiency/cost measurement tools.
• Evidence-based decision-making skills; ability to review past history, benefits information, policies and financial as well as other data to make sound, informed decisions in a timely manner.
• Keen ability to effectively synchronize and drive forward work holistically across the enterprise, with an executive presence, to effectively communicate, consult on, and deliver complex information with varied audiences.
• Demonstrated leadership experience, including building/developing high performing teams. Establishes clear goals/expectations and motivates teams to achieve success and is flexible and adaptable to changing priorities.
• Requires a product management mindset for overall end-to-end success of projects including financial, business, and operational results.
• Strong abilities in utilizing critical thinking to evaluate complex systems and processes; create and implement recommended changes to processes and organizational structure to increase quality and efficiencies.

Responsibilities

• Drive critical business strategy and outcomes as well as align leadership around Wellmark’s total cost of care (TCOC) initiatives.
• Serve as a trusted advisor to Health Care Innovation (HCI) leadership and be viewed as a matrixed leader among others across the organization.
• Partner extensively with internal stakeholders to implement and measure the success of cost of care initiatives.
• Drive strategy and ideas through the creation and facilitation of multi-year business cases for Health Care Innovation (HCI) initiatives.
• Support initial sizing and business case analysis and partner with project and initiative resources across various Wellmark departments to achieve results.

Preferred Qualifications

• Master’s degree in business (MBA).
• Health plan experience.