Health Management Director

Location
Durham, North Carolina
Posted
Nov 29, 2016
Specialty
Public Health
Position Type
Permanent

The Health Management Director is responsible for building out and leading the HCW health management platform and team to provide health management consultation and innovative solutions to help clients with controlling health care costs. This position will have a presence in the health care marketplace to champion and collaborate with providers, insurers, third party service providers, and clients in developing the health management platform.

The Health Management Director is a leader, both internally in supporting HCW culture and keeping staff engaged, and externally with client interactions. This position understands the needs of larger groups and takes a creative and futuristic approach when working with these clients. The person in this role has the knowledge and skills necessary to understand the variety of options available to larger groups and is able to deal with more complex benefit plans and issues.

ESSENTIAL DUTIES AND RESPONSIBILITIES

Other duties may be assigned to meet business needs.

  • Innovates, builds, and maintains the Health Management Platform to ensure effective consultation, implementation, and management of health care costs and solutions by HCW’s Health Management Advisors and Consultants for middle market employers.
  • Communicates persuasively the business case for health management to engage employers in taking action to control costs with knowledge of health management concepts and business acumen.
  • Asserts leadership in crucial conversations with the client and assists in developing a health management strategy and plan of action with clients.
  • Assists clients with large claims review, through review of patient medical records, and talking with insurers and providers to assess future claims costs.
  • Leads collaboration between providers, insurers, third party service providers, and clients to create innovative solutions in cost control.
  • Develops, executes, and maintains a repeatable process to evaluate and implement innovative solutions to control costs with third party service providers and carriers for the health management platform.
  • Employs CRM (InforCRM) to manage calendar, activities, to-do items, and tickets.
  • Creates and delivers thought leadership presentations in sales and marketing events (such as seminars, trade shows, associations, and business professional meetings) on population health management topics and innovative solutions to health management.
  • Writes and presents for HCW educational and marketing programs using business acumen, domain knowledge, and expertise in the industry.
  • Positions self as an expert in participating in educational marketing opportunities at industry conferences and networking within associations, affinity partners, etc.
  • Works collaboratively with Business Development and Marketing to convert prospects to clients.
  • Keeps HCW team educated and updated on the cutting edge of health management.
  • Leads and directs a team of Health Management Advisors to the successful execution of the platform.
  • Performs managerial duties including recruiting, training, supervising, and evaluating department staff.

QUALIFICATIONS/REQUIREMENTS

  • MD or DO, current license, and board certified required.
  • Master’s degree preferred or commensurate experience.
  • 7+ Years’ experience in professional services and or clinical organization.
  • Continued work at a clinic one day per week required.
  • Management experience or experience leading a team preferred.
  • Industry experience and/or product knowledge in employee benefits preferred.
  • Experience with population health management required.
  • Knowledge of health management concepts.
  • Strong analytical skills.
  • Excellent communication and presentation skills to effectively communicate with people at all levels from department managers to C-Suite executives.
  • Creative problem-solving and strong interpersonal skills.
  • Ability to embrace and respect the team culture approach.

KSAOs

Knowledge

  • Knowledge of the insurance and healthcare industry terminology and familiarity with how benefits work for a consumer. 
  • Basic understanding of HIPAA is preferred.
  • Knowledge of population health management and health management concepts.
  • Strong business acumen.
  • Working knowledge of insurance products and provider networks is preferred.

Skills

  • Public Speaking – has the ability to deliver clear and easy to understand presentations that are convincing and capture the audience’s attention. 
  • Meeting Management - can successfully prepare for, facilitate, and present client meetings in a professional manner.
  • Relationship Building - builds constructive and effective relationships both internally and externally to gain trust and influence to better serve the client.
  • Problem Solving - knows how and where to look for answers; uses logic and other methods to find the most effective solution to client issues.
  • Networking - makes connections and networks in the business community and with the carriers in order to better serve the client; remains active and credible in the business community.
  • Communication skills - excellent communication skills, both written and verbal, to effectively and professionally communicate with a variety of different personalities and individuals; serves as a story-teller by rolling up complex information and presenting in an easy to understand manner.
  • Project Management - knows how to organize people and activities to achieve results such as leading the team assigned to a client; works well with different personalities.
  • Listening - practices attentive and active listening while using patience in order to understand the client’s needs and act accordingly.
  • Detail- Oriented - has the ability to see the details in a large amount of information, such as those present in rules and regulation, to better serve the client.
  • Organization - can organize and compile large amounts of complex data and information into an easily understood manner.
  • Time Management - prioritizes multiple activities to value time and manages deadlines effectively to meet the needs of the client.
  • Even-tempered - has the ability to remain calm in difficult situations in the face of the client; does not become defensive or irritated when things become difficult.

Attributes

  • Emotional Intelligence - able to identify, assess, and control the emotions of oneself or of others, especially useful in the presence of the client and working with client issues.
  • Integrity - admits mistakes and can be trusted by the client.
  • Perceptive - understands and recognizes the needs of others and is open to new ideas.
  • Positive Attitude - works through daily activities in an upbeat manner and does not allow for difficult situations to become a setback.
  • Sociable - easily communicates with others and enjoys a sociable atmosphere.
  • Self-Motivated - has the inner focus and drive to start and lead projects and activities.
  • Confident - has confidence in the ability to do one’s job; acts boldly, and sure of oneself in the face of the client.

Tools

  • HCW Templates - uses premade templates to assist with the implementation process.
  • InforCRM - inputs client profile data and for plan/employer information to best serve the client.
  • Checklists - utilizes organization checklists in order to efficiently complete tasks and processes.
  • Microsoft Office (e.g. Word, Excel, PowerPoint, Publisher, Outlook) – has advanced knowledge of these products and utilizes them to communicate, create, and update the client in support of their benefit plans.