Executive Director, Clinical Policy

Job Duties and Responsibilities


* Represent ESI and Evicore regarding clinical and PBM policy, serving as a leader externally with policymakers on issues relevant to the external environment to testify at the State and Federal levels on issues of clinical and business impact, i.e., utilization management, interoperability/automation, and clinical affairs spaces, to achieve policymaker and patient impact.

Must have excellence in distilling difficult concepts to understandable and impactful level.


* Develop multi-year strategic plan template to adapt for planning efforts a strategy, tactical plan on impacting policymaker views so the business may achieve growth, revenue and earnings goals across the PBM and clinical divisions holistically.

Examples:
+ Must be able to specifically deliver an ambitious plan that demonstrates meaningful and measurable progress to ensure external environment understands options, evidence, benefits of our enterprise PBM and clinical spaces.
+ Must be able to discuss digital engagement as a scalable medical affairs solution to deliver across large patient populations.
+ Must be able to come up with innovative approaches related to new models of care for the government, identifying evidence needs of patients, providers, and payers.


* Develop messaging for policymakers to increase understanding regarding our enterprise activities, championing innovation, patient outcomes and addressing issues evolving in the ecosystem.

Examples:
+ Must be able to clearly articulate the PBM and overall utilization management value proposition.
+ Must be able to message and discuss clinical decision processes on how we look at optimal care and be able to quantify the impact of clinical affairs activities to reduce suboptimal care.
+ Must be able to establish and clearly articulate our enterprise strategy regarding medical engagement that impacts on care delivery.
+ Must be able to discuss automation of medical processes.


* Engage with stakeholders and drive collaboration models with provider groups, including national physician and hospital organizations and patient advocacy groups to achieve our strategic goals.


* Use business and financial acumen to gather and analyze data and develop insights to drive appropriate conclusions about the strategic and financial attractiveness of concepts/initiatives.


* Collaborate with internal and external business development contacts to facilitate cross-functional initiatives.


* Manage tight deadlines for multiple competing priorities, scope, and converging opinions to solution in a timely manner.

Qualifications


* Thought leader with substantive health policy background.


* Proven track record for success in a matrixed environment.


* Demonstrated leadership related to challenging problems with examples of implementing innovative analytic and environmental solutions.


* 10+ years e...