Vice President Hcc Risk Adjustment Coder Jobs in Pittsburgh, PA

GENERAL OVERVIEW:

The Vice President, Chief Medical Information Officer (VP/CMIO) for Allegheny Health Network (AHN) is a strategic executive role responsible for architecting the digital future of care delivery. This position synthesizes advanced digital ecosystems into a cohesive "Operating System for Health," leveraging AHN's clinical footprint to validate and scale digital interventions across Highmark Health's diverse membership. The VP/CMIO drives clinical and digital transformation, balancing strategic vision with operational execution and clinical diplomacy to advance the "Living Health" model.

ESSENTIAL RESPONSIBILITIES

• Drive Digital Transformation, Innovation, and Workflow Optimization: Lead cultural and operational changes for new technology adoption, foster innovation through "Living Laboratory" functions, synthesize diverse digital tools into a cohesive "Operating System for Health," and strategically optimize clinical systems to enhance clinician experience, reduce administrative burden, and improve clinical decision support and documentation quality. (25%)

• Perform management responsibilities to include, but not limited to: involved in hiring and termination decisions, coaching and development, rewards and recognition, performance management and staff productivity. Plan, organize, staff, and manage the day-to-day operations of the team; develop and implement policies and programs as necessary; manage to assigned budgets. (20%)

• Develop and Lead Clinical Informatics Strategy & Governance: Formulate and execute the clinical IT strategy, chair the Clinical Informatics Council (CIC) to prioritize IT requests, manage vendor relationships for clinical technology solutions, and oversee enterprise standards to reduce unwarranted clinical variation. (20%)

• Maintain Active Clinical Practice and Foster Cross-Functional Collaboration: Engage in part-time clinical practice to maintain credibility with medical staff and ensure a firsthand understanding of clinical workflows and needs. Act as a primary liaison between the clinical enterprise, health plan, and technology divisions to ensure alignment and facilitate the successful integration of digital solutions. (20%)

• Advance Population Health Management, Clinical Analytics, and Data Integrity: Integrate and operationalize data-driven insights for risk stratification, value-based care performance, and social determinants of health. Oversee compliance with relevant healthcare regulations and standards related to clinical informatics, ensuring the integrity and security of clinical data. (15%)

• Other duties as assigned or requested.

QUALIFICATIONS:

Required

• Doctorate's degree in Medicine (MD or DO)

• 10 years of experience in Deep expertise in the implementation and optimization of enterprise-level electronic health record systems and related clinical information systems.

• 5 years of experience in Progressive leadership experience in Clinical Informatics.

• 5 Experience within an Integrated Delivery Network (IDN) or health system with a health plan component, involving value-based care contracts, risk adjustment, and claims data.

• 5 years of experience in Proven track record of leading large-scale change management initiatives related to clinical technology adoption and workflow transformation.

• 3 years of experience as a Chief Medical Information Officer (CMIO), Associate CMIO, or equivalent in a large, complex health system.

• Active, unrestricted PA medical license

Preferred

• Master's degree in Medical Informatics, Health Administration (MHA), Business Administration (MBA), Medical Management (MMM), or Public Health (MPH)

• Board Certification in Clinical Informatics (ABPM)

SKILLS:

• Strategic Vision

• Political Savy & Emotional Intelligence

• Data Literacy

• Resilience

• Communication

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.

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