Senior Vice President/Chief Clinical Administrative Officer | UPMC Insurance Services Division | UPMC Health Plan

University of Pittsburgh Medical Center

  • Location: Pittsburgh, PA

UPMC is seeking a Senior Vice President/Chief Clinical Administrative Officer to serve the UPMC Insurance Services Division/UPMC Health Plan. The University of Pittsburgh Medical Center (UPMC) is seeking a Senior Vice President/Chief Clinical Administrative Officer to serve the UPMC Insurance Services Division/UPMC Health Plan. UPMC Insurance Services Division provides health coverage and benefit management for 3.5 million members, and includes the UPMC Health Plan, UPMC for You, UPMC for Life, Community Care Behavioral Health Organization and Work Partners. These health benefits companies manage health services for Commercial, Medicaid, Medicare, CHIP, Behavioral Health, EAP, Health Promotions and Worker’s Compensation programs. UPMC Health Plan Commercial HMO was rated 4.5 out of 5 in NCQA Private Health Insurance Plan Ratings in 2018-2019. UPMC Health Plan PPO, Medicaid, and Medicare products were ranked 4 out of 5 in 2018-2019.

UPMC is a $20 billion healthcare provider and the largest nongovernmental employer in Pennsylvania, integrating 87,000 employees, 40 hospitals, and 700 doctors’ offices and outpatient sites. Working in close collaboration with the University of Pittsburgh Schools of the Health Sciences, UPMC shares its clinical, managerial, and technological skills worldwide through its innovation and commercialization arm, UPMC Enterprises, and through UPMC International.

Position Overview

The Senior Vice President/Chief Clinical Administrative Officer will facilitate the mission and vision of UPMC Insurance Services Division clinical enterprise. This position will be accountable for ensuring that all members receive exceptional service that is commensurate with improved health outcomes.  In concert with the Chief Medical Officer, this role is responsible for the overall strategy, stewardship and organizational success of the following:

  • All clinical/case management teams and the overall care management pillar.
  • Population health strategic solutions; including design, engagement and optimization.
  • Care management innovation and new models of engagement with providers, employers, members, and community stakeholders.
  • Patient centered medical home management and person-centric, value-based care across the healthcare continuum.

Qualifications

The ideal candidate will offer:

  • Executive leadership background in a nationally ranked managed care organization or risk-bearing health system with a substantial number of covered lives.
  • Strong background overseeing the care management pillar, leading large teams to organizational success, exceeding quality goals.
  • Thought leadership and acumen in developing and implementing innovative clinical delivery initiatives, new models of care, and population health initiatives across the spectrum of care.
  • Strong executive presence and background serving on the senior management team, with success in meeting financial, quality, and service targets.
  • Passion for applying technology in healthcare innovation; solid understanding of appropriate metrics, measures, and outcomes, displaying a keen ability to work in a data driven environment.
  • Master’s degree and 8+ years operational leadership experience, with either a clinical or applicable administrative educational background.