Clinical Transformation Physician Executive

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Clinical Transformation Physician Executive

120 5th Avenue Place, Pittsburgh PA 15222-3099, United States

Full time

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Job DescriptionWorking with UsBenefits & PerksHear From Our TeamHow We Hire

Job Details

Category Clinical Services

Type Full time

Location(s) 120 5th Avenue Place, Pittsburgh PA 15222-3099, United States

Brand Highmark Health

Posted 11/10/2026

Req ID J281036

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Job Description

Company :

Highmark Health

Job Description :

JOB SUMMARY

This job will serve as the clinical dyad to the provider partnerships market leader. This incumbent is accountable for the clinical aspect of opportunity identification, design, readiness, and adoption of the living health solutions and programs to reinvent health. The Incumbent will manage clinical capability assessments and interaction with provider systems to determine feasibility and consistency of adopting best practice approaches to achieve the best health outcomes. Will identify new opportunities based on clinical insights, define meaningful interventions and lead communication and change management support. The incumbent will partner with the provider leaders to ensure expert clinical resources and other provider partner resources needed for an effective implementation and transformation process are deployed.

ESSENTIAL RESPONSIBILITIES

• Serve as the clinical dyad to the living health partnership market leader and co-lead the coordination of solution opportunity, design, readiness, and adoption at provider partners.

• Represent the clinical point of view on

• All decisions related to the identification, build-out and management of solutions at provider partners.

• Opportunities to incorporate solutions from provider partners into Living Health.

• Serve as an ambassador for Highmark Health and its strategy to provider partners in the context of this role.

• Assist in the development of the implementation framework, playbook, and approach for bringing innovative clinical solutions to provider partners.

• Work with clinicians and administrators to identify key variability challenges and engage appropriate clinical expertise across multiple provider systems for validation and involvement in the process of solution design.

• Partner with the living health partnership market leader on program and clinical process adoption, activation of onsite work streams, and engagement of administration across provider partners.

• Develop and enhance clinical leadership relationships with community hospitals, independent physicians and clinically integrated networks (CINs) in the region, to expand and solidify the presence of Highmark Health.

• Provide other clinical duties as assigned within the enterprise.

EDUCATION

Required

• Doctor of Medicine (MD) or Doctor of Osteopathic Medicine (DO)

Substitutions

• None

Preferred

• None

EXPERIENCE

Required

• Practicing physician with at least 10+ years clinical practice

• Board Certified physician with a current, unrestricted medical license in any US State

• Demonstrated record of clinical leadership, including experience leading multi-disciplinary clinical teams and multi-specialty physician groups

• Experience working in a highly matrixed clinical structure

Preferred

• None

LICENSES or CERTIFICATIONS

Required

• Current MD or DO; Must hold a current board certification in field of study

Preferred

• None

SKILLS

• Successfully partners through collaboration and sense of urgency regarding process implementation and improvement/optimization.

• Experience in matrix management, including own function and providing matrix oversight to others

• Ability to critically appraise and apply the latest medical evidence to inform clinical pathways and care models

• Strong analytical skills to identify complex clinical and operational challenges and develop innovative solutions

• Experience with Value Based Care programs and the needed population health infrastructure, quality processes and care management support to be sucessful

• Ability to understand and interpret complex healthcare data (e.g., claims data, EHR data, quality metrics) to identify trends, opportunities, and areas for improvement. Utilization of data to inform clinical strategy, measure outcomes, and demonstrate value.

• Understanding the financial drivers of healthcare, including reimbursement models, cost-effectiveness, and resource allocation. Capacity to evaluate the financial impact of clinical transformation initiatives to inform financial modeling

• Highly motivated with exceptional organizational skills, including the ability to effectively and competently handle multiple responsibilities simultaneously and the flexibility and ability to quickly adapt to changes in work objectives, promotions, and available technology

• Demonstrated success in building organizational consensus and leading by influence

• Strong oral and written communication skills, can visually convey concepts

• Ability to present complex concepts clearly and concisely to a wide range of audiences

• Exhibits problem solving skills and productively manages conflict

Language (Other than English):

None

Travel Requirement:

0% - 25%

PHYSICAL, MENTAL DEMANDS and WORKING CONDITIONS

Position Type

Most On-the-Road

Teaches / trains others regularly

Occasionally

Travel regularly from the office to various work sites or from site-to-site

Frequently

Frequently

Physical work site required

Yes

Lifting: up to 10 pounds

Constantly

Lifting: 10 to 25 pounds

Occastionally

Lifting: 25 to 50 pounds

Never

Disclaimer: The job description has been designed to indicate the general nature and essential duties and responsibilities of work performed by employees within this job title. It may not contain a comprehensive inventory of all duties, responsibilities, and qualifications required of employees to do this job.

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.

Highmark Health and its affiliates prohibit discrimination against qualified individuals based on their status as protected veterans or individuals with disabilities and prohibit discrimination against all individuals based on any category protected by applicable federal, state, or local law.

California Consumer Privacy Act Employees, Contractors, and Applicants Notice

Why Choose Highmark Health?

At Highmark Health, we are on a mission to reinvent healthcare for everyone. When you bring your curiosity and drive to our award-winning team, you will find continuous opportunities to grow your career, break down barriers in the industry, and make a meaningful impact every day.

Benefits & Perks

Taking Care of You

Your Benefits at a Glance

• Health: Complete medical, dental, vision, prescription, HSA, and FSA coverage.
• Time Off: Paid vacation, holidays, and dedicated volunteer time.
• Finance: Employer-sponsored 401(k), life/disability insurance, and tuition reimbursement.
• Perks: Exclusive team discounts on shopping, memberships, and events.

Medical Coverage

Medical, prescription drug, dental, and vision coverage

Paid Time Off

Vacation, holidays, volunteering

Retirement Package

Employer-sponsored 401(k) plan

Insurance & Coverage

Life, AD&D and disability insurance

Onsite & Preventative Care

We make staying healthy easy with 100% covered preventative exams (including flu shots) and onsite pharmacy services at major campuses. Plus, stay active with free fitness center access at major Highmark campuses, Allegheny General, and West Penn Hospital.

Make Mindful Changes

Secure bicycle parking at major campuses. Healthy food options at onsite cafeterias. Stress management classes including yoga, mindfulness, and meditation.

Holistic Support, 24/7

Work-life resources including assistance programs and financial counseling services. 24/7 telephone access to health and wellness coaching.

Get Rewarded for Giving Back

Health incentive program that rewards team members. Team member networks to gather in the name of health. Paid volunteer time and incentives for making a difference.

Hear from Our Team

Real people, real stories

"I have met some really great people over the years at Highmark Health and the company has treated me really well. I get really good benefits. I"ve always been rewarded for working hard. That"s what keeps me here."

Victoria T.

Associate Strategy Analyst, enGen

"I love participating with the PRIDE BRG. It"s an engaged, dynamic group of almost 400 people. I also love to turn on the digital hub on my computer and see what"s going on with any of the Business Resource Groups. It"s really neat to be able to support other BRGs and see others support PRIDE. Every time I go to a different BRG event, I always feel welcome, even if I"m not part of that group."

Amanda M.

Director of Social Determinants of Health | Vice Chair of PRIDE

Our Hiring Process: Step-by-Step

1. Apply

Find a role that sparks your passion and submit your application! We'll send an immediate confirmation email, and our team will review your qualifications over the next 1-2 weeks.

2. Interview

If your profile is a great match, we'll reach out to schedule your interview-whether by phone, video, or in person. Don"t worry, we'll provide all the prep details in advance so you can shine.

3. Job Offer

The moment you've been waiting for! If selected, we'll connect to celebrate and walk you through the details: compensation, benefits, paid time off, and all the perks of joining the team.

4. Pre-Employment

After you accept online, we'll guide you through standard screening (including a background check and drug screen, plus health screenings for certain clinical roles). Once cleared, we"ll officially confirm your start date!

5. Onboarding

Welcome aboard! Before Day 1, we'll send everything you need to hit the ground running-including your schedule, location, and the required identification documents to bring with you.

Bonus Fast-Track Tip

Applying for EVS, Dietary, or Customer Service roles? You can skip the traditional line and chat with Bridget, our AI recruiting assistant, to find open roles and schedule an eligible interview instantly.

Apply Now

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Highmark Health is an independent licensee of the Blue Cross Blue Shield Association.

Highmark Health and its affiliates prohibit discrimination against qualified individuals based on their status as protected veterans or individuals with disabilities, and prohibit discrimination against all individuals based on their race, color, age, religion, sex, national origin, sexual orientation/gender identity or any other category protected by applicable federal, state or local law. Highmark Health and its affiliates take action to employ and advance in employment individuals without regard to race, color, age, religion, sex, national origin, sexual orientation/gender identity, protected veteran status or disability.

We endeavor to make this site accessible to any and all users. If you would like to contact us regarding the accessibility of our website or need assistance completing the application process, please contact the email below. For accommodation requests, please contact HR Services Online at HRServices@highmarkhealth.org

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