Program Manager, SCO
Company: Point32Health
Location: Sharon
Posted on: August 7, 2022
Job Description:
The Program Manager, SCO, will be
primarily responsible for implementing key SCO initiatives, and
supporting SCO product strategy development and bid filing. The
Program Manager is responsible for supporting strategy development
and coordinating execution efforts for the SCO business. The role
works closely with colleagues in Sales & Marketing, Actuarial,
Network Contracting, Clinical Services, IT, and Operations to
develop and execute new initiatives that will support the SCO
business objectives, including membership growth, revenue
optimization, and cost containment. The Program Manager also
supports implementation of SCO product strategy through
collaboration with the Director of Product Strategy/Bid
Implementation and other internal and external stakeholders
including vendors. In addition, the Program Manager, SCO Product
will represent THP or support interactions with the State EOHHS as
well as with the implementation of Medicaid Contracts and other
State mandates affecting the SCO business.Job DescriptionProduct
Strategy Support
- Support development of SCO product strategy and annual bid for
Massachusetts
- Partner with the Bid Implementation team, Compliance, and Sales
& Marketing to ensure SCO product offerings and member materials
are compliant with CMS and MassHealth rules and regulations
- Support SCO Head of Sales to foster effective execution and
realization of sales objectives / goals (e.g., operations, product,
network, etc.)
- Assess changes in the external environment including state and
federal regulations, identify implications and support development
of plans to address
- Support analysis and content development to advance strategic
discussions with key business partnersProduct Management
- Business Performance Support, as needed, including the
development and implementation of business performance plans and
medical cost improvement initiatives that deliver on our revenue
and margin targets
- Collaborate with Business Performance to track key SCO product
management metrics and align reporting infrastructure
- Manage SCO vendors, including facilitating vendor performance
review meetings, resolving vendor related issues, completing
vendor-related Corrective Action Plans (CAPs), etc.
- Work with stakeholders as necessary to address day-to-day SCO
related issues.
- Monitor / Manager / Oversee operational functions supporting
product and any corrective action plans, as neededBusiness Case
Development / Vendor Implementation
- Support development of business cases for SCO product
improvement, including for benefits / vendor partnerships that will
drive growth, retention, revenue management and margin goals
- Partner cross-functionally to support development and
implementation of business cases that will improve Product
positioningInteractions with State Medicaid Agency
- Support THPs Executive-level representation and support of
day-to-day interactions with the State EOHHS, including monthly
conference calls or ad hoc calls/meetings to discuss matters
affecting SCO business
- Manage the State Medicaid Contract renewal process in
partnership with stakeholders including Medicaid Compliance team,
and work with stakeholders to implement new mandates included in
such contracts
- Manage or support implementation of all other State mandates
and processes such as participation in Consumer Advisory Board
meetings and establishment and management of SCO Member Governing
Board, as well as any related reporting to Corporate or State
entitiesSupport SCO financial and other reporting requirements as
necessaryRequirements EDUCATION: (Minimum education &
certifications required)
- Bachelors degree is required, Masters preferred.EXPERIENCE:
(Years of experience)
- 5-8 years of experience in strategic / business planning or
product / new business development, including project management
and data analysis / reporting with demonstrated execution of
business case development and leadership of strategic initiatives.
Experience developing and owning new initiatives in a dynamic
environment preferred. Prior health industry experience is
essential. Health insurance and / or provider / network experience
preferred; experience with Dually eligible populations and plans
preferred.SKILL REQUIREMENTS: (Include interpersonal skills)
- Problem solving across a wide range of business situations
- Ability to understand and use data to inform decisions
- Ability to perform basic analysis and create appropriate
reports as needed to help deliver insights
- Ability to understand the divisions end-to-end business model
and key performance metrics
- Excellent written and oral communication skills
- Comfort with ambiguity and change
- Ability to prioritize and work on multiple projects
simultaneously
- Ability to manage projects, priorities, and ensure timely
execution
- Ability to interact and develop relationships with stakeholders
in a matrixed organizational settingCONFIDENTIAL DATA: All
information (written, verbal, electronic, etc.) that an employee
encounters while working at Tufts Health Plan is considered
confidential. Exposed to and required to deal with highly
confidential and sensitive material and must adhere to corporate
compliance policy, department guidelines/policies and all
applicable laws and regulations at all times.What we build together
changes our customer's health for the better. We are looking for
talented and innovative people to join our team. Come join
us!Please note: As of January 18, 2022, all employees including
remote employees must be fully vaccinated. This position will
require the successful candidate to show proof of full vaccination
against COVID-19. Point32Health is an equal opportunity employer,
and will consider reasonable accommodation to those individuals who
are unable to be vaccinated consistent with federal, state, and
local law.About Us:Point32Health is a leading health and wellbeing
organization, delivering an ever-better health care experience to
everyone in our communities. Building on the quality, nonprofit
heritage of our founding organizations, Tufts Health Plan and
Harvard Pilgrim Health Care, we leverage our experience and
expertise to help people find their version of healthier living
through a broad range of health plans and tools that make
navigating health and wellbeing easier.At Point32Health, were
working to reshape the world of health care by pushing past the
status quo and delivering even more to the diverse communities we
serve: more innovation, more access, more support, and healthier
lives. And we want people like you on our side to make it even
better.This job has been posted by TalentBoost on behalf of
Point32Health. TalentBoost is committed to the fundamental
principle of equal opportunity and equal treatment for every
prospective and current employee. It is the policy of TalentBoost
not to discriminate based on race, color, national or ethnic
origin, ancestry, age, religion, creed, disability, sex and gender,
sexual orientation, gender identity and/or expression, military or
veteran status, or any other characteristic protected under
applicable federal, state or local law.Req ID: R4781
Keywords: Point32Health, Boston , Program Manager, SCO, Executive , Sharon, Massachusetts
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