Job Description
Company : Highmark Inc. Job Description : JOB SUMMARY This job is responsible for the overall clinical support of account and sales specific activities within the Clinical Services division. The incumbent works with leaders in clinical services and sales/account management as a liaison, developing collaborative relationships across departments such as sales, actuary, underwriting, product and marketing to provide clinical content research for clients, clinical expertise for high-cost reporting, RFP responses, preparation for client meetings, and tracking of performance guarantees including participation in strategies to improve outcomes. ESSENTIAL RESPONSIBILITIES Develop collaborative relationships across various departments such as sales, actuary, product, marketing and others, as identified. Actively collaborate with account managers, clinical sales consultants, and other key stakeholders in preparation for client meetings. Support sales when prepping for client meetings. Provide support for sales finalist meetings from a clinical services perspective by providing the clinical insight into value to members and clients. This is a client-supporting role. Support the clinical management team to assure that there are clear expectations for Case Managers & Disease Managers as it relates to specific models and client accounts. Provide new client implementation and ongoing support for clinical teams for buy-up products. Work with clinical managers to coach nurses on identified opportunities specific to client expectations. Serve as primary leader in coordination and preparation for client audits and clinical reviews assuring that all requirements established by the client including contractual obligations are met and staff involved in any onsite reviews are adequately prepared and coached. Work with the Member Listening System (MLS) team to align new cohorts or changes in existing cohorts to maintain contractual agreements. Liaison between Sales and Clinical teams to fi
