Director Clinical Programs

Job Summary

Highmark Health is seeking an experienced and strategic healthcare leader to serve as the Director of Clinical Programs. In this role, you will lead the strategy, design, and optimization of innovative, technology-enabled care models for high-need chronic populations across our integrated delivery system.

You will direct multidisciplinary teams to deliver coordinated, patient-centered care that improves health outcomes, closes care gaps, enhances member experience, and reduces the total cost of care. As a key leader in care transformation, you will drive scalable solutions that advance quality performance, operational excellence, and sustainable value.

Essential Responsibilities

• Perform management responsibilities to include, but are not limited to: involved in hiring and termination decisions, coaching and development, rewards and recognition, performance management and staff productivity. Plan, organize, staff, direct and control the day-to-day operations of the department; develop and implement policies and programs as necessary; may have budgetary responsibility and authority.
• Develop and monitor clinical quality programs in partnership with Medical Directors and direct reports.
• Act as Executive Sponsor for continuous improvement initiatives. Lead a team to develop new processes and workflows to enhance program efficiency, staff satisfaction and patient clinical outcomes.
• Collaborate with Management and Risk Assessment leader to work toward shared outcomes.
• Collaborate with Workforce Operations team. Ensure decisions are driven by data and follow an agreed upon problem solving methodology.
• Partner with departments in the enterprise on projects related to care delivery, shared savings, and organizational goals.
• Assess readiness for strategic growth including but not limited to increased caseload geography, and care delivery model.
• Provide vision for incorporating population health strategies into workflow.
• Other duties as assigned or requested.

Required

• 5 years in a PA-C or CRNP role
• 5 years in a management or leadership role
• 5 years of Project/workgroup Leadership

Preferred

• 1 year in Palliative Care/Hospice
• 1 year in Community Based Healthcare

Skills

• People Leadership
• Continuous Improvement or Project Work
• Quality Assurance
• Interdisciplinary Team Work
• Oral and Written Communication
• Leading different disciplines to achieve shared goals
• Delivery of Virtual Healthcare Visits
• Customer service skills
• Ability to establish and maintain effective relationships
• Ability to work in collaboration with Medical Director(s)

Required

• Physician Assistant or Master's Degree in Nursing

Preferred

• None

LICENSES or CERTIFICATIONS

Required

• Current Physician Assistant License or Current State RN licensure OR Current multi-state licensure through the enhanced Nurse Licensure Compact (eNLC) and CRNP license.

Preferred

• None

Language (Other than English): None

Travel Requirement

0% - 25%

PHYSICAL, MENTAL DEMANDS and WORKING CONDITIONS

• Position Type
• Non-office based
• Teaches / trains others
• Frequently
• Travel from the office to various work sites or from site-to-site
• Occasionally

Works primarily out-of-the office selling products/services

• Never
• Physical work site required
• Yes
• Lifting: up to 10 pounds
• Constantly
• Lifting: 10 to 25 pounds
• Occasionally
• Lifting: 25 to 50 pounds
• Rarely

Additional Employment Requirements

• Basic Life Support (BLS)

Compliance Requirement

This job adheres to the ethical and legal standards and behavioral expectations as set forth in the code of business conduct and company policies.

As a component of job responsibilities, employees may have access to covered information, cardholder data, or other confidential customer information that must be protected at all times. In connection with this, all employees must comply with both the Health Insurance Portability Accountability Act of 1996 (HIPAA) as described in the Notice of Privacy Practices and Privacy Policies and Procedures as well as all data security guidelines established within the Company's Handbook of Privacy Policies and Practices and Information Security Policy.

Furthermore, it is every employee's responsibility to comply with the company's Code of Business Conduct. This includes but is not limited to adherence to applicable federal and state laws, rules, and regulations as well as company policies and training requirements.

California Consumer Privacy Act Employees, Contractors, and Applicants Notice