Director, Product Data Management and Operations

Point32Health • Canton, MA

4d

About The Position

The Director of Configuration and Operations of the claim adjudication systems. drives configuration strategy and execution, ensuring accurate setup of claims adjudication, products, benefits, payment processes and automation of business processes. Leads high-performing teams and oversees vendor partnerships to optimize system capabilities and deliver enhancements aligned with organizational goals. Collaborate with senior leadership and cross-functional stakeholders to design scalable, cost-effective solutions that improve operational efficiency and compliance. Serve as a strategic advisor for configuration governance, risk mitigation, and resource planning, reducing administrative costs while enhancing quality and member experience. Champion innovation by envisioning and implementing transformative business processes across the enterprise.

Requirements

• Education, Certification and Licensure Required: Bachelor’s degree required or equivalent experience
• Experience (minimum years required): Required: 10-15 years of relevant experience
• Leadership and management skills are necessary.
• Must be able to communicate effectively with all levels of management and work cooperatively as a team member.
• Ability to lead, direct and motivate large teams effectively and manage through influence.
• Superior problem solving and process management skills.
• Ability to prioritize work and operate under very tight deadlines.
• Motivated and flexible, able to work independently.
• Ability to collaborate effectively and regularly with staff at the highest levels of the organization.
• General knowledge of business processes and budgeting protocols
• Possess proven abilities in relationship and change management
• Must be able to work under normal office conditions and work from home as required.
• Work may require simultaneous use of a telephone/headset and PC/keyboard and sitting for extended durations.
• May be required to work additional hours beyond standard work schedule.

Nice To Haves

• Preferred: Master’s degree preferred.

Responsibilities

• Hires, manages, and trains both direct and non-direct staff with specific domain knowledge in configuration related business applications.
• Continuously evaluates system capabilities to meet business needs and facilitate enhancements.
• Implement and maintain business application systems.
• Coordinate application upgrades, testing, changes, and patching.
• Defines and monitors key operational metrics, ensuring transparency through clear communication, and driving organizational improvements by addressing performance gaps.
• Drives operational improvement programs, including ongoing development of a cross functional monitoring program and ensure ongoing compliance to regulatory, contract and internal procedures, with an ability to report out on performance, benefit realization as well as monitor and course correct, as necessary.
• Represents Operations at enterprise-wide functional areas across forums; communicates and manages plans, status, risk mitigation.
• Proactively works cross-functionally to identify and manage enterprise-wide interdependencies.
• Designs and implements tactical and operational plans that impact department and related department results.
• Oversees vendor activities, performance, service level requirements, and on-going relationship building.
• Develops project plans specifying goals, strategy, staffing, scheduling, risks, contingency plans, and allocation of available resources as project scope and size require.
• Monitors department performance against goals and targets to ensure timeliness, accuracy, adherence to metrics and take action to address gaps, missed targets and inventory builds.
• Persuades and influences internal and external relationships of critical importance as needed to ensure Operations and organizational objectives are met.
• Other duties as assigned.

Benefits

• Medical, dental and vision coverage
• Retirement plans
• Paid time off
• Employer-paid life and disability insurance with additional buy-up coverage options
• Tuition program
• Well-being benefits
• Full suite of benefits to support career development, individual & family health, and financial health

What This Job Offers

• Job Type: Full-time
• Career Level: Director
• Number of Employees: 1,001-5,000 employees