Performance Sustainability Manager

Amerihealth Caritas•Washington, DC

4d•$116,700 - $159,000•Hybrid

About The Position

As the Performance Sustainability Manager for the Healthy DC Plan, you will report directly to the Director Operations and drive product performance across key functional areas against established performance metrics. AmeriHealth Caritas is a mission-driven organization with more than 30 years of experience. We deliver comprehensive, outcomes-driven care to those who need it most. We offer integrated managed care products, pharmaceutical benefit management and specialty pharmacy services, behavioral health services, and other administrative services.

Requirements

Bachelor’s Degree required
Experience in payor operations
Minimum of 3 years of experience leading cross-functional teams and involvement in helping frame, design and execute solutions for challenging enterprise priorities
Experience leading implementation-centric change
Ability to manage multiple tasks simultaneously and to proactively assess project status and highlight potential risks
Ability to work effectively with colleagues at all levels, including ability to manage through influence
Excellent presentation skills, including strong verbal and writing capabilities
Self-starter with an entrepreneurial outlook
Team player who manages with courage, flexibility and versatility
Expertise in Tableau for data visualization and dashboard creation
Strong experience in Excel, Power BI, and other data analytics tools

Nice To Haves

Master's Degree preferred

Responsibilities

Develops and implements performance metrics that enable measurement of progress on internal metrics and regulatory requirements, including call center SLAs, member and provider grievance & appeals, claims timeliness, provider credentialing, UM turnaround times.
Responsible to drive product strategy and planning aimed to improve business results based on continuous improvement that is aligned with enterprise strategy. Oversee the progress of Healthy DC Plan initiatives to ensure progress against business goals, identify risks before they become issues.
Collaborates with other leaders in the company, including Executive Team members, to identify opportunities for improvement in plan overall performance.
Partners with internal stakeholders and work with our vendors to drive towards top performance on metrics.
Partners with Business Performance Reporting to support metrics required for business reviews. Coordinates problem resolution efforts with the Medical Affairs and Provider Services departments regarding complaints and grievances pertaining to quality of care or providers.