VP Enhanced Community Care Management

Highmark Inc

Pittsburgh, PA

JOB DETAILS
SKILLS
Alliance/Partner Management, Budgeting, Business Administration, Business Development, Business Strategy, Business Transformation, Change Management, Clinical Medicine, Coaching, Communication Skills, Computer Security, Corporate Policies, Cost Control, English Language, Facebook, Federal Laws and Regulations, HIPAA (Health Insurance Portability and Accountability Act), Health Insurance, Healthcare, Healthcare Administration, Information/Data Security (InfoSec), Insurance, Internet Security, Leadership, Legal Standards, LinkedIn, Medicine, Nursing Administration, Operations Management, Palliative Care, Patient Care, Performance Management, Policy Development, Policy Implementation, Process Improvement, Productivity Management, Provider Relations, Regulatory Compliance, Risk Analysis, Sales, Security Policy, State Laws and Regulations, Strategic Planning, Team Lead/Manager, Twitter, Willing to Travel, YouTube
LOCATION
Pittsburgh, PA
POSTED
30+ days ago

Apply for VP Enhanced Community Care Management | Careers at Highmark Health

Skip to main content Careers Working here Our Companies Career Areas Early Careers Interns Talent Community Team Member Stories Veterans Explore Jobs Clinical Services VP Enhanced Community Care Management Explore our jobs VP Enhanced Community Care Management Apply Open in new tab icon

Pittsburgh, PA 15222 FAP 5th Avenue Place Company Endorsed Job Description

JOB SUMMARY

The leader of the ECCM organization will be accountable to execute on the strategic vision and direction to transition the organization into its next phase of growth with accountability over three new verticals including palliative care, complex care management, and a comprehensive risk assessment function. This role will be accountable for the implementation of key initiatives and approaches to enable and accelerate this transition that will drive an improved patient experience, lower cost of care, and deliver on C2V targets for the Segment. The role will be responsible for the strategy development and ongoing strategy evolution along with deep operational management and expertise to ensure that the three verticals are functioning effectively and efficiently and that the back-office functions are supporting each of the verticals in the optimum way to drive value. This position would strategically enhance Highmark Health by building out resources and developing the value proposition to differentiate Highmark Health in the marketplace across a variety of content areas including care model redesign, operating model enhancement, care management, and navigation, and financial value integration. This position reports to the SVP Home and Community Care.

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

Use an integrated provider-payor lens to create an operating model and deploy unique approaches to a variety of content areas including care model redesign, value-based payment, care management, and navigation, and financial value drivers.

Collaborate with physicians and other clinicians to identify areas of opportunity for value improvement.

Lead and design deployment of select initiatives that enable the transformation to value-based care. Ensure that all current clinical initiatives are meeting established objectives.

Develops and implements policies and programs. Develop relationships that can help others understand and buy into the purpose of our value-based approach with an ability to articulate a compelling vision. Operationalize strategy by managing change to drive success and achievement in a heavily matrixed environment.

Other duties as assigned or requested.

EXPERIENCE

Required:

  • 10-15 years of experience with Healthcare Industry
  • 10-15 years of experience with Insurance Industry
  • 8-10 years of experience with Leadership
  • 8-10 years of experience with Management
  • 10 years of experience with Provider Relations
  • 10 years demonstrated Operational Excellence

Preferred:

  • None

SKILLS

  • Business Development
  • Building and Leading Teams
  • Business Strategy
  • Business Transformation
  • Strategic Planning
  • Strategic Relationship Building
  • Provider Relations
  • Organizational Change Management
  • Management

EDUCATION

Required:

  • Bachelors of Nursing, Business Administration, or Health Administration, or relevant experience and/or education as determined by the company in lieu of a bachelors degree.

Preferred:

  • Masters Degree
  • Doctor of Medicine (MD)

LICENSES or CERTIFICATIONS

Required:

  • None

Preferred:

  • None

Language Other than English:

  • None

Travel Required:

  • 0 to 25

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 companys Handbook of Privacy Policies and Practices and Information Security Policy. Furthermore, it is every employees responsibility to comply with the companys 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.

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.

California Consumer Privacy Act Employees, Contractors, and Applicants Notice

Apply Job Details

Job category: Clinical Services Position Type: Full Time Posted: 2026-01-30T00:2901.5743770000 Locations: Pittsburgh, PA 15222 FAP 5th Avenue Place Line of Business: Entity Recruiter: Hiring Manager Experience Level: Req ID J274985

Share Facebook X LinkedIn Whatsapp Email Copy URL Apply Open in new tab icon Arrow left icon Twitter icon Facebook icon Linkedin icon Instagram icon Youtube icon Glassdoor icon Featured Links Competitively Sensitive Information Cyber Security Notice at Collection E-Verify English E-Verify - Employee Rights and Responsibilities Data Protection Sitemap Terms of Service Do Not Sell Share E-Verify Spanish Digital Privacy Policy 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 any category protected by applicable federal, state, or local law.

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.

Copyright 2025 Highmark Health. All Rights Reserved.

About the Company

H

Highmark Inc

Highmark provides millions of people with the security of quality health insurance

Our history of helping families and companies with their health insurance needs dates to the 1930s, when our predecessor companies were established to help Pennsylvania's residents pay for health care.

Highmark was created in 1996 by the consolidation of two Pennsylvania licensees of the Blue Cross and Blue Shield Association — Pennsylvania Blue Shield (now Highmark Blue Shield) and Blue Cross of Western Pennsylvania (now Highmark Blue Cross Blue Shield). We are now one of the largest health insurers in the United States.

Highmark's officers and board of directors set the company's strategic direction and corporate policies. They are guided by our mission, vision and values.

COMPANY SIZE
1,000 to 1,499 employees
INDUSTRY
Healthcare Services
FOUNDED
1996
WEBSITE
https://www.highmark.com/hmk2/index.shtml