Senior Manager - Evidence Based Medicine Services

In addition to the responsibilities listed below, this senior manager position is also responsible for providing high-quality analytical and methodological consulting and expertise to evaluate the efficacy/effectiveness and safety of clinical interventions and new medical technologies of strategic importance to the organization. This includes managing rigorous systematic or rapid evidence reviews, meta-analyses, cost-effectiveness and other analyses to answer high-impact clinical questions; managing teams in the evaluation the research methods and statistical findings of health outcome studies retrieved from systematic searches of the medical literature; and ensuring established frameworks and tools are used to evaluate, grade, summarize and present findings on the quality of the evidence to senior level audiences.

This position is also responsible for educating key stakeholders, providing expert level consultation on evidence-based methods, presenting findings of evidence assessments, and driving consensus for the development of clinical recommendations and evidence statements to support decision making for diverse stakeholders (e.g., senior regional clinical leaders, quality improvement, care management, business consulting, resource utilization, member services, benefit policy development, administrative and operations staff). This includes managing and informing leaders on the identification and evaluation of clinical interventions to improve clinical and operational quality, efficiency, and affordability of health care. This also includes ensuring relevant information from industry, health plan, regulatory, government, and other sources are used to inform decision making related to clinical guidelines, medical technologies, and evidence-based implementation strategies.

• Creates and advocates for developmental opportunities for others; builds collaborative, cross-functional relationships. Solicits and acts on performance feedback; works with leaders and employees to set goals and provide open feedback and coaching to drive performance improvement. Pursues professional growth; hires, trains, and develops talent for growth opportunities; strategically evaluates talent for succession planning; sets performance management guidelines and expectations across teams / units. Oversees implementation, adapts, and stays up to date with organizational change, challenges, feedback, best practices, processes, and industry trends; shares best practices within and across teams. Fosters open dialogue amongst team members, engages, motivates, and promotes collaboration within and across teams; motivates teams to meet business objectives. Delegates tasks and decisions as appropriate; provides appropriate support, guidance and scope; encourages development and consideration of options in decision making; fosters access to stakeholders.


• Manages designated units or teams by translating business plans into tactical action items; oversees the completion of work assignments and identifies opportunities for improvement; ensures all policies and procedures are followed; partners with key stakeholders and business leaders to ensure products and / or services meet requirements and expectations while aligning with departmental strategies. Aligns team efforts; builds accountability for and measuring progress in achieving results; assumes responsibility for decision making; fosters direct reports to resolve escalated issues as appropriate. Communicates goals and objectives; incorporates resources, costs, and forecasts into team and unit plans; ensures matrixed resources are fulfilling service or performance requirements across reporting lines. Removes obstacles that impact performance; identifies and addresses improvement opportunities; guides performance and develops contingency plans accordingly; influences teams and units to operate in alignment with operational and business objectives.


• Manages a team of consultants to ensure the alignment, buy-in, and coordination of diverse stakeholders to drive successful initiatives and projects within care delivery or clinical settings across one or more technical areas or workstreams by making significant contributions and/or providing leadership to high visibility projects to identify and resolve issues of strategic importance to the organization; identifying and ensuring representation and inclusion of appropriate stakeholders and team members; building rapport and partnerships with stakeholder teams, third party vendors, and senior/executive management to produce results that are outcome driven; working with stakeholders to set the strategic direction of initiatives, develop goals and set the prioritization of deliverables; discussing involvement of key processes (e.g. quality management, project change management, communication) and facilitating decisions necessary for the delivery of initiatives; communicating tough issues to stakeholders while maintaining an independent perspective; providing expertise and recommendations; developing written materials for senior executives and other key clients; and making formal presentations and providing reports to various senior and/or executive level audiences.


• Manages a team of consultants in the development of requirements, for complex clinical, process, or system solutions multiple technical area(s) by partnering with senior and/or executive stakeholders and cross-functional teams as appropriate; providing guidance in the use multiple requirements gathering methodologies to identify clinical, functional, and non-functional requirements; monitoring the development and documentation of comprehensive case studies to assess the costs, benefits, and ROI of proposed solutions; collaborating in the development of results-driven action plans; and leading team members in the development process as appropriate.


• Manages the development and implementation of multiple clinical initiatives, systems, and processes to a desired future state by maintaining an advanced understanding of how current processes impact clinical operations across one or more technical areas; mapping current state against future state processes; identifying the operational impact of requirements on upstream and downstream solution components; providing options and recommendations to senior and/or executive management and clinical stakeholders on how to integrate solutions and deliverables with current systems and processes across regions or technical areas; and identifying and validating value gaps and opportunities for process enhancements or efficiencies.


• Monitors clinical or care delivery strategy and ensures organizational alignment and prioritization of clinical initiatives by developing and determining goals and priorities with management team sponsors; defining, developing, and evaluating performance metrics, standards, and methods to establish success; partnering with senior and/or executive stakeholders, often with competing/conflicting objectives, to ensure cohesive and reachable metrics; refining strategic plans and performance metrics as appropriate; and proactively monitors complex initiatives or portfolio to ensure delivery of measurable results and alignment with strategic objectives.


• Serves as a lead advocate of continuous learning and professional development by keeping abreast of industry practices, standards, and benchmarks; attending and presenting at roadshows, conferences, and speaking events; overseeing the ongoing enhancement and innovation of clinical consulting practices, standards, and methods across KP; serving as an advocate to ensure continuous learning and improvement is championed as a people strategy; and providing ongoing coaching to build a continuous improvement mindset and build capabilities that drive results.


• Manages complex, highly visible projects or project components by partnering with clinical leadership and key stakeholders; providing guidance on assembling teams based on project needs and team member strengths; overseeing the development, analysis, and management of project plans, including proposed project structure, approach and work plan; negotiating time commitments and resources; coordinating project schedules and resource forecasts; proactively monitoring, identifying, and resolving project or clinical initiative risks, issues, and trigger events; developing mitigation plans and strategies; resolving or escalating risks or issues as appropriate; and providing leadership advice to project teams, as well as managing the work of outside consultants when needed.


• Manages change management activities associated with care delivery or clinical initiatives by engaging and influencing stakeholders to obtain support and buy in for changes; partnering with senior and/or executive management, project champions, and clinical owners to communicate and align improvement initiatives with strategic objectives; recommending and determining appropriate change management method and approach; and ensuring stakeholders embrace a change management mindset, understand intent and purpose, and foster a culture of change.


• Manages team members in performing complex data analyses to drive care delivery or clinical initiatives by recommending appropriate data analysis tools and approach to assess performance; empowering team members to utilize suitable data gathering and analysis methods (e.g., process observation, hard data, etc.); defining data requirements and obtaining customer agreements, including customer requirements as appropriate; and forecasting and alleviating risks through data-driven analysis.


• Directs vendor management as required by monitoring vendor performance levels; ensuring service level agreements are met; managing vendor invoices; and partnering with Procurement, Legal, and/or clinical leadership teams to develop service level and/or scope of work agreements as appropriate.


• Monitors and takes accountability for the compliance of team work activities by ensuring business plans and team members adhere to KP, departmental, and/or clinical policies and procedures.