Manager, Program Management

Point32Health • Remote Worker Home Office (MA), MA

1d • $121,943 - $182,915 • Hybrid

About The Position

The SCO Care Management program has grown and will continue to grow, in membership, regulatory complexity, and operational scope, exceeding the capacity of existing clinical management structures. While Clinical Managers focus on frontline execution, there is no centralized accountability for program performance, regulatory readiness, audit response, and cross product alignment across SCO and D SNP programs. A dedicated Program Performance Manager will serve as the single point of accountability for SCO Model of Care integrity, audit coordination, MDS HC/UCA quality oversight, performance reporting, and continuous improvement. Under direction of the Director, manages programs and projects with significant complexity, risk and/or cost related to compliance and quality as well as manages 3 or more direct reports. Initial key responsibilities will include: Regulatory & Compliance Leadership • Serve as the SCO Care Management regulatory and contract subject matter expert • Own audit readiness and response for State, CMS, and internal monitoring • Translate Model of Care and regulatory requirements into operational workflows, training, and documentation standards • Ensure alignment of policies and procedures with evolving regulations (e.g., UCA, eCAS, CTD→MHK) Program Performance & Quality Oversight • Own and monitor program level KPIs (Stars, HEDIS, utilization, transitions of care, MDS performance) • Lead cross functional performance improvement initiatives • Ensure Care Management readiness for new system launches and regulatory changes Strategic Enablement & Sustainability • Act as the primary liaison between Care Management, Product, Population Health, Compliance, and IT • Maintain centralized governance for policies, training content, and regulatory guidance • Ensure continuity and sustainability of improvements post implementation

Requirements

• Bachelor’s Degree required
• 8-10 years' business or industry experience.
• 5-8 years of program management experience, including leading significant cross-functional, high-level initiatives.
• Using knowledge of company, able to resolve most roadblocks to program progress.
• Able to operate in a matrixed environment.
• May need to coordinate the participation of other internal contacts to develop and or maintain programs.
• Able to navigate political issues using advanced organizational knowledge.
• Is an effective advocate for program, and negotiates/leads others both internally and externally to participate in the program.
• May be required to coach/mentor less experienced program managers and effectively lead in a matrixed environment.
• Proactively identifies conflict/integration issues and leads team members to parse/synthesize issues of the highest complexity.
• Able to identify risk out of the larger picture and has a proven ability to accurately estimate and plan resource usage.
• Able to identify and make decisions that serve the best interests of Point32Health.
• Detailed content knowledge of the specific program.
• Must be able to converse and lead dialogue on the subject with minimal direction
• Ability to thrive in a matrix-management, hands-on environment that demands a consultative approach and solutions that span multiple environments in a business area.
• Outstanding communication and relationship management skills required, including the ability to effectively manage difficult group dynamics to effectively reach a positive outcome.
• Excellent human resource management skills, ability to oversee team of program managers as part of the overall program.
• Highly developed oral and written communication skills, ability to communicate with and influence internal and external constituents at all levels with confidence.
• Highest level presentation skills including ability to interface and “sell” new programs and changes to existing programs to a broad range of internal and external contacts, as necessary.
• Ability to interact with confidence with external and senior management.
• Strong negotiating, influencing, and advocacy skills, ability to lead others both internally and externally to ensure the success of the program.
• Ability to navigate political issues using advanced organizational knowledge.
• Must be flexible and a proponent/champion of change, able to conceptualize and envision the impact of change, and propose new ways to do business.
• Must be an accomplished multi-disciplinary team-leader and team-builder with hands-on style.
• Ability to lead teams whose members have diverse professional and educational backgrounds, and to effectively manage difficult group dynamics to effectively reach a positive outcome.
• Ability to present technical information in a way that establishes rapport, persuades others, and gains understanding.
• Highly developed verbal and written skills, ability to facilitate planning and review sessions with senior mgmt., high level presentation skills including ability to interface and “sell” new programs and changes to existing programs to a broad range of internal and external contacts, as necessary.
• Requires the ability to maintain effective and productive peer relationships.
• Must have the ability to motivate fellow employees by fostering team spirit, an attitude of cooperation, and a commitment to the organization.
• Requires well-developed interpersonal skills to act in the capacity of liaison to the user community.
• Possess strong influencing skills with the ability to manage and motivate both direct and non-direct reports.
• Must have a demonstrated ability to obtain the confidence and trust of non-reports, resulting in high commitment and cooperation.

Nice To Haves

• Master’s degree preferred
• PMP Certification preferred.
• PMP eligibility required.
• advanced training in the field related to the program is preferred.

Responsibilities

• Overall program ownership and management of key programs, focusing on both short-term initiatives and long-term strategic direction and objectives for the programs.
• Development, implementation, and oversight of the Program including but not limited to leading interpretation and implementation of new regulatory guidance and prepare, providing consultation to staff on compliance issues and processes and coordinating responses for all internal and external activities across LOBs.
• Oversees all activities and responsibilities of the quality team including but not limited to Manages the design/development, implementation, evaluation, and report writing of quality improvement programs and projects
• Collaborates with business partners to conduct secondary research and to design and implement qualitative and quantitative analysis as needed.
• Formulates findings, draws conclusions, makes recommendations for action and works with stakeholders to document the findings and reports based on the data.
• Responsible for the timely completion of all activities and final deliverables that meet requirements for the QI programs.
• Leads the major Program for the department and organization including collaborating with colleagues across the organization, participating as a member of organization Parity Core team, leading the implementation of organization wide parity champion program.
• Leads regular cross functional informational or working meetings, including effective agenda planning, facilitation, and tracking/follow up on deliverables until closed. Meetings include, but not limited to, Business Stakeholders and Operations Working team.
• Other duties and projects 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: Manager