Medicaid Fee-For-Service Operations Manager (Program Manager III)

MedImpact Healthcare Systems, Inc.•San Diego, CA

6d•$102,260 - $178,955•Hybrid

About The Position

This position works within the State of South Carolina, preferably in the area of Columbia, SC. This position is contingent upon MedImpact's successful award and/or implementation of new business. Employment in this role is dependent upon the final business award, client approval (if applicable), and organizational staffing requirements. MedImpact reserves the right to modify or withdraw this opportunity based on business needs. The Program Manager III works in one of three areas: Value Based Care (VBC), Government Programs & Services or PDP (MedGenerations) and is responsible for analyzing, creating new requirements, planning, and delivering updates for assigned programs and related services. For GPS & MedGenerations specifically, the Program Manager works within one or more regulated market lines of business – Medicare Part D, Marketplace, Prescription Drug Plan (PDP) or the Medicaid plans including: Medicaid Fee for Services (FFS), Medicaid Managed Care (MMCO), Children’s Health Insurance Plan (CHIP).

Requirements

BS/BA and 9+ years’ experience or equivalent combination of education and experience, and 6 years' of SME in respective areas
Advanced knowledge of Microsoft Office software (Outlook, Word, Excel and PowerPoint)
Advanced knowledge of MS Project and Visio
Intermediate knowledge of at least one content management system (e.g. SharePoint, Confluence, wiki)
Demonstrated ability to learn new software tools
Excellent communication skills (written/verbal).
Proven ability to plan and facilitate effective meetings.
Skilled at business requirements gathering and ability to prepare and maintain detailed project plans
Ability to manage multiple projects simultaneously and prioritize competing demands.
Advanced presentation skills with the ability to present information at varying levels of abstraction depending on audience
Good organization skills and attention to detail.
Basic process improvement skills (e.g. tools and practices from agile, lean, six sigma)
Basic to intermediate product management skills
Strong problem-solving skills to handle: (1) problems that span a single area (2) problems that span multiple areas, and (3) facilitate across functional teams in developing solutions.
Ability to effectively lead and influence cross-functional as well as virtual teams including remote participants.
Ability to apply common sense understanding to carry out instructions furnished in written, oral, or diagram form. Ability to deal with problems involving several concrete variables in standardized situations.
Ability to add, subtract, multiply, and divide in all units of measure, using whole numbers, common fractions, and decimals. Ability to compute rate, ratio, and percent and to draw and interpret bar graphs.
Ability to read and interpret documents such as safety rules, operating and maintenance instructions, and procedure manuals.
Ability to write routine reports and correspondence. Ability to speak effectively before groups of customers or employees of organization.

Nice To Haves

SQL query development
Golden32 or other equivalent database browsing software
Excel macro programming
PMP or other project management certification

Responsibilities

Drives the development of the overall strategy and roadmap, research, requirements, and coordination for assigned programs.
Follows outlined program management processes to manage the overall scope, planning, business requirements, implementation and delivery of software updates and other related requirements to assigned programs. Ensures business requirements are properly translated into customer deliverables. Schedules product release timelines with IT department. Coordinates product development schedules and releases to production.
Drives appropriate work process improvement activities.
Defines and documents business requirements for new products or services, through market analysis or other innovation strategy. Interfaces with end-users and business analysts to define business rules as they apply to processes and procedures; documents business requirements and develops work- flow diagrams, functional hierarchies, process models, revenue models and fee schedules. Prepares program development objectives and schedules all phases of program development and introduction to clients. Schedules product release timelines with the IT department. Coordinates technical product development and releases to production.
Keeps current with and reviews state and/or federal requirements and regulations related to assigned programs to ensure that programs support client regulatory compliance.
Provides day-to-day management and coordination of deliverables, issue tracking, and compliance issues for assigned programs. Ensures timely delivery of reports. Communicates to both internal and external clients on status, schedules, and changes.
Coordinates the efforts of multi-disciplinary teams throughout various stages of the program development life-cycle. Manages large-scale, strategic, complex projects from start to finish and effectively leads project teams comprised of multiple business units.
Develops client communications as needed to explain MedImpact response and/or changes in client responsibilities (related to drug benefit management). Attends client calls as needed to understand and address questions or issues for assigned programs.
Maintains documentation for assigned programs including: Program Descriptions, Report Guides, Policies, Procedures, Work Instructions, training materials, etc.
Serves as an expert resource for the line of business or for Government Programs and Services the focus will be on at least one regulated market, in addition to being a subject matter expert in assigned programs. Educates clients on program features. Provides expertise and training to other departments.
Mentors less experienced program management team members and aids in cross training.
Defines metrics to effectively measure the success of program and service processes and deliverables.
Monitors vendor operations, ensures appropriate metrics and PG’s are in place, and coordinates vendor changes as appropriate with MedImpact automation and/or work processes.