Program Manager II - Payment Integrity

Point32Health • Canton, MA

1d • Hybrid

About The Position

The Program Manager II is responsible for projects and initiatives with significant cross-functional interface that support assigned programs and/or vendors. Responsibilities include managing major departmental programs with significant cross functional interface with moderate complexity, risk and/or cost. Responsibility may include development of new programs as well as management of ongoing programs. Changes to programs require some negotiation and change management skills to implement. By using knowledge of the company, the Program Manager II should be able to resolve most roadblocks to ensure success and progress. The Program Manager II should make recommendations for change by performing cost/benefit analysis and by using basic analytical and problem-solving capabilities to support the recommendation. Will also directly interact with internal and external leadership from both Point32Health and key clients and/or vendors.

Requirements

• Bachelor’s degree or equivalent work experience is required.
• 3-5 years of professional experience.
• Excellent verbal and written communication skills generally acquired through college or other advanced education is required.
• Well-developed verbal and written skills, ability to facilitate planning and review sessions.
• High level presentation skills including ability to interface effectively with external contacts and/or clients.
• Ability to exercise sound judgment and raise issues to appropriate team members or management for resolution.
• Ability to conceptualize the impact of change and propose new methods of conducting business.
• Ability to use analytical skills to develop new or implement change to existing program functions.
• Ability to interpret and explain the implications of planned changes to current state business units.
• Ability to problem solve and overcome obstacles to ensure successful program operations.
• Proficiency with MS Office applications (Word, Excel, PowerPoint).
• Ability to utilize multiple applications simultaneously.
• Requires the ability to work cooperately as part of a team.
• Must be able to effectively communicate with all internal departments in verbal and written formats.
• Requires some presentation experience.
• Must be able to work in a matrix environment with minimal supervision.
• The position may require a background investigation and fingerprint form on file with the US Office of Personnel Management. Questionnaire For Public Trust Position (standard form 85P) must be completed and approved.
• Access to several secure government websites may be needed.

Nice To Haves

• Master’s degree.
• 3-5 years of health plan experience with 6-8 years working experience.
• Program management or equivalent experience leading significant department level initiatives.

Responsibilities

• Manage ongoing assigned program operations and/or vendors. This may include working with multiple areas within the organization and directly with clients and/or vendors to ensure effective, accurate, timely processes and workflows.
• Use analytic skills to develop or improve programs including business opportunity definition and research.
• Perform detailed policy and impact analysis as it relates to the current programs, clients and/or vendors; make recommendations for process and/or policy change; present to various levels of the organization and the client the findings and summary options. This includes determining data scope, consulting with many Point32Helath staff, performing analyses, and determining both quantitative and qualitative business implications.
• Lead and/or manage projects and/or initiatives by representing program operations during planning and implementation phases. This may include support of other company programs and coordinating issue resolution with relevant functional business areas and leading and/or facilitating planning and review sessions.
• Lead regular cross functional informational or working meetings, including effective agenda planning, facilitation, and tracking/follow up on deliverables until closed.
• 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: Mid Level