Director Clinical Value Portfolio Mgt

$142,700 - $239,000/Yr

Emergent Holdings - Grand Rapids, MI

Full-time - Senior

Grand Rapids, MI

Management of Companies and Enterprises

About the position

The Director of Clinical Value Portfolio Management at Emergent Holdings is responsible for overseeing clinical care delivery and driving strategic initiatives to enhance clinical value and cost savings. This role involves collaboration with leadership and clinicians to develop care delivery strategies, manage vendor relationships, and ensure compliance with regulations. The position plays a critical role in the growth of membership and the execution of multi-year initiatives aimed at achieving clinical value and medical cost savings.

Responsibilities

• Develop the care delivery strategy for Emergient in collaboration with leadership and clinicians.
• Coordinate medical policy committees and manage vendor relationships.
• Review data and analytics to ensure compliance with CMS final rules.
• Serve as the clinical program consultant for AEP activities.
• Manage the development of a pipeline of opportunities to achieve clinical value.
• Formalize plans for delivery of multi-year initiatives to achieve clinical value and medical cost savings.
• Lead annual efforts to support Bid submission for Senior Health Services.
• Facilitate executive level discussions and engage executives to support strategic objectives.
• Drive execution of program efforts and ensure alignment of work efforts.
• Manage issue escalation and resolution across the organization.

Requirements

• Bachelor's degree in a related field required.
• Master's degree in public health, health care administration or other related field preferred.
• Valid Michigan Accident and Health Insurance License required.
• Valid and unrestricted driver's license required.
• Ten years of progressively more responsible experience in a business environment.
• Seven to ten years' experience working in a health insurance plan or public health agency.
• Five years management or supervisory experience in business required.

Nice-to-haves

• Bilingual skills preferred.
• Certification or progress toward certification is highly preferred.

Benefits

• Competitive salary range of $142,700 - $239,000.
• Opportunities for continuous learning and professional development.