Director - Cost of Care

Job description

About the Role: As a vital member of the Wellmark leadership team, you will directly drive critical business strategy and outcomes as well as align leadership around Wellmark’s total cost of care (TCOC) initiatives. Total cost of care cannot be viewed independently because it involves many intertwined initiatives with up and down stream impacts, this position must leverage health and/or pharmacy clinical (pharmacy preferred) expertise to effectively synchronize, influence, and drive forward decisions holistically across the enterprise. As a Cost of Care Director, you will serve as a trusted advisor to Health Care Innovation (HCI) leadership and will be viewed as a matrixed leader among others across the organization. You will be responsible for partnering extensively with internal stakeholders to implement and measure the success of cost of care initiatives – driving strategy and ideas through the creation and facilitation of multi-year business cases for Health Care Innovation (HCI) initiatives. You’ll support initial sizing and business case analysis and partner with project and initiative resources across various Wellmark departments to achieve results. Preferred Qualifications - Great to have: • Master’s degree in business (MBA). • Health plan experience. Required Qualifications - Must have to be considered: • 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. • Plus, a minimum of 5 years of demonstrated broad-based health care and/or pharmacy background. Must have 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, to quickly build rapport, credibility, and collaborative partnerships with team members, senior leaders, and stakeholders (including vendors and providers). • 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. • Must have a 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 (i.e., dataset presentation) with varied audiences, such as internal and external leaders, team members, vendors, or customers, which also includes senior leadership and Board of Directors. • 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. • Some travel may be necessary. Why Wellmark : We are a mutual insurance company owned by our policy holders across Iowa and South Dakota, and we’ve built our reputation on over 80 years’ worth of trust. We are not motivated by profits. We are motivated by the well-being of our friends, family, and neighbors–our members. If you’re passionate about joining an organization working hard to put its members first, to provide best-in-class service, and one that is committed to sustainability and innovation, consider applying today! Learn more about our unique benefit offerings here .