Program Manager, Medicare Advantage Association Program

<strong>At Emergent Holdings, we&rsquo;re creating an innovative environment where our employees belong authentically, contribute meaningfully, and thrive intentionally &mdash; both personally and professionally.</strong>

Southfield, USA

Emergent Holdings

<p class="p1"><strong>Emergent Holdings is driven by a singular goal &mdash; improving the health and safety of our customers and our communities. How do we do that? We create innovative insurance products, technology solutions, and services to support our key stakeholders &mdash; individuals, employers, providers, and strategic partners &mdash; improving the health and safety of the people and places we serve.</strong></p>

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Competitive Compensation and Benefits Package

Overview: <br />The Program Manager, MA Association Program is responsible for supporting BCBSA Medicare Advantage Coordination of Care (OOA) program and projects. Duties associated with this position involve implementation of OOA-related initiatives and monitoring the overall program/project progress. The role will integrate, align and grow the capabilities of program and work across business units and teams to identify opportunities, drive improvements and ensure program and project timelines are met.&nbsp;<br /><br /> This role collaborates with multiple functional areas requiring a combination of focus and flexibility, as well as a willingness to play an active, behind-the-scenes role. The Program Manager exercises broad discretion and judgment in the acquisition and dissemination of information. The Program Manager understands multiple perspectives of health care, government programs, nonprofit and for-profit business, operational issues, and impact.<br /><br /><br /> <p><strong>WORKING CONDITIONS:</strong></p> <p>Work is performed in an office and/or remote setting with no unusual hazards. Occasional travel required.</p>
Responsibilities: <br /> <ul> <li>Manage plan-to-plan, vendor, and internal communications to drive operational outcomes for the MA Coordination of Care (OOA) program.</li> <li>Manage and maintain on-going production data collection and file exchange efforts across the enterprise.</li> <li>Plans, organizes, and directs activities of assigned initiatives and programs. Provides project coordination and management of on-going enhancements across the enterprise.</li> <li>Leads program meetings and drives key decisions with all stakeholders to define project initiation requirements, ongoing monitoring, success criteria and facilitates conflict resolution and prioritization of implementation/production issues.</li> <li>Drives key decisions with all stakeholders to define project/program initiation requirements, ongoing monitoring, and success criteria.</li> <li>Establishes a refined body of metrics related to intake, execution, and delivery of initiatives in the clinical operations portfolio.</li> <li><a target="_blank">Proactively follows-up on open issues with senior leadership, as well as other relevant parties, in order to implement solutions in a timely and quality fashion.</a></li> <li><a target="_blank">Works with project managers and business leads to develop business cases, understand project scheduling, outcomes and assure program objectives are met</a></li> <li>Maintains and provides information about current projects and potential future projects as required.</li> <li>Identify, create, establish and maintain reporting deliverables for budget, performance, and project status. Research and resolve discrepancies in existing reporting deliverables.</li> <li>Clearly communicates policies and procedures as they relate to governance management and metric reporting.</li> </ul>
Requirements: <br /> <p><strong>EDUCATION:</strong></p> <ul> <li>Bachelor&rsquo;s degree in Business, healthcare, or a related field.</li> <li>Master&rsquo;s degree in healthcare administration, business or public health is preferred.&nbsp;</li> <li>Relevant combination of education and experience may be considered in lieu of degree.</li> <li>Continuous learning, as defined by the Company&rsquo;s learning philosophy, is required.&nbsp;</li> </ul> <p>&nbsp;<br /><strong>EXPERIENCE:</strong></p> <ul> <li>A minimum of seven years of multi-faceted experience in the healthcare industry, project management environment or a related field with demonstrated technical knowledge that provides the necessary skills, knowledge, and abilities.&nbsp;</li> <li>Prior electronic data exchange experience strongly preferred.&nbsp;</li> </ul> <br /> <p><strong>SKILLS/KNOWLEDGE/ABILITIES (SKA) REQUIRED:</strong></p> <ul> <li>Demonstrated leadership skills.</li> <li>Demonstrated task and relationship management skills.</li> <li>Excellent verbal, interpersonal, and written communication skills.</li> <li>Working knowledge of electronic data exchange concepts, file formats, and processes.</li> <li>Demonstrated knowledge and experience in Medicare Advantage business, risk, and quality programs including but not limited to risk adjustment, STARs, HEDIS, and provider value-based programs.</li> <li>Strong program management leadership, facilitation, negotiation, team coaching, and collaboration skills.</li> <li>Knowledge of industry best practices, regarding program and project management principles and tools.</li> <li>Proven ability to work independently in a team-oriented environment.</li> <li>Ability to plan and carry out responsibilities with minimal direction.</li> <li>Strong organizational skills and ability to handle multiple tasks in a fast-paced environment.</li> <li>Ability to manage multiple priorities and meet necessary deadlines.</li> <li>Ability to effectively exchange information clearly and concisely, present ideas, report facts and other information, respond to questions, and employ active listening techniques.&nbsp;&nbsp;&nbsp;</li> <li>Ability to apply the principles of independent logical, analytical thinking to define problems, collect data, establish facts and draw valid conclusions.</li> <li>Ability to interact with others to build consensus and get decisions implemented.</li> <li>Results-oriented and ability to manage multiple tasks simultaneously.</li> <li>Ability to handle sensitive and confidential information.</li> <li>Knowledge of Microsoft packages, including Project, PowerPoint, Word, and Excel.</li> <li>Strong understanding of the importance of detail.</li> <li>Skilled at managing stakeholder groups and balancing diplomacy and tact with assertiveness.</li> <li>Excellent prioritization skills to balance key priorities.</li> <li>Strong customer-centric approach.</li> <li>Effective in unifying and creating teams of people with disparate skills.</li> <li>Courageous and decisive, prioritizes effectively, maintains a clear focus, and sees action through to delivery.</li> <li>Energetic, determined, positive, goal-focused, and consistent, even when under pressure.</li> <li>Ability to build trust and demonstrates integrity in all circumstances.</li> </ul>