Description
The National Medicare Administration team is seeking an Implementation/Program Manager to oversee the implementation of a Dual Eligibility Enrollment and Member Assistance pilot program.
This position provides an excellent opportunity to make a difference by providing important services and support to the underserved or lower income population. The initial program launch will focus on a subset of our Medicare membership. The program is expected to help qualifying members subsidize their Medicare premiums and/or cost-sharing, and/or to help them through the application process to receive other types of community based assistance, eg, food banks, utility subsidies, transportation services.
The individual in this role will provide overall program management across multiple workstreams, and will coordinate closely with internal resources as well as with an outside vendor that will be engaged to conduct member outreach. After the implementation phase is complete, the individual in this role may continue to oversee the ongoing program operations, including vendor management and performance measurement and monitoring.
Essential Functions:
Accountable for a successful implementation of the Dual Eligibility Enrollment and Member Assistance pilot program.
Develops and maintains a detailed implementation plan, manages issues and risks, and provides executive status briefings on implementation progress.
Establishes and leads cross-functional workgroups.
Identifies and coordinates with other project managers and implements schedule deadlines in a matrixed environment with informal authority.
Conducts an operational readiness assessment prior to program launch.
Accountable for tracking and/or monitoring the results of actualization of benefits and program metrics.
Coordinates and participates in a research program to determine the impact of community-based services provided to members.
Works with National Medicare Finance to ensure that vendor bills are validated and promptly paid.
Responsible for ongoing program optimization in collaboration with the selected vendor and various internal functions to generate high levels of Dual Eligibility enrollment as well as a highly effective Member Assistance program.
Responsible for ongoing vendor management.
Travel required 10-20% of the time.
Basic Qualifications:
Requires excellent oral and written communication skills as well as business presentation skills.
Excellent analytical skills.
Interfaces effectively with all levels and across organizational lines, including the business units.
Effectively utilizes external vendors and internal resources.
Demonstrated success at building team relationships and partnerships across organizational lines.
Experience Level:
BA or BS required, PMP or Project Management Professional Certification highly desirable; plus minimum 7+ years of direct relevant experience.
Preferred Qualifications:
Independent thinker with proven leadership skills.
Relationship builder.
5 years of experience in healthcare administration, or 5+ years of experience working in an area/industry relevant to the current posting.
Successful prior experience with vendor alliance management.
PMP Certification and/or formal training in Project Management methodologies.
Knowledge of Medicare, Medicaid, Dual Eligibility (Medicare/Medicaid), and/or the uninsured populations.
Knowledge of Call Center operations and/or prior experience with outreach programs.
Broad knowledge of the Healthcare industry.
Experienced in the application of principles, theories, and concepts to support social and health related challenges of underserved or lower income populations.
Manages a complex group of portfolio projects and acts as a change agent. Maintains a strategic focus, and manages complex inter-project relationships. Ability to lead and provide an environment with project managers and project leads that drives to superior results despite challenges. Manages a project utilizing proprietary process for Project Management. Manages supply and demand to ensure adequate resources are available and delivery commitments are met.