Sr Program Manager

Who We Are

Point32Health is a leading health and wellbeing organization, delivering an ever-better personalized health care experience to everyone in our communities. At Point32Health, we are building on the quality, nonprofit heritage of our founding organizations, Tufts Health Plan and Harvard Pilgrim Health Care, where we leverage our experience and expertise to help people find their version of healthier living through a broad range of health plans and tools that make navigating health and wellbeing easier.

We enjoy the important work we do every day in service to our members, partners, colleagues and communities.

Job Summary

The Sr. Program Manager will be responsible for the implementation, execution and general ownership of risk adjustment programs, including chart reviews, in-home health assessments, prospective data decision support and other new programs for the Risk Adjustment department. The Sr. Program Manager will also help to lead the design, contracting and implementation of new risk adjustment programs or expansions into new markets. This individual will oversee and manage relationships with vendors, monitor and evaluate their performance, and implement performance improvement measures as necessary. The Sr. Program Manager will work with business partners to analyze operational workflows and identify solutions that will enhance risk adjustment performance. This individual will often serve as the risk adjustment subject matter expert while initiating, supporting and leading collaboration efforts within the department and across the company. The Sr. Program Manager will also support provider engagement and consultation efforts by serving as an expert on our program details and operations to provider organizations. This individual regularly demonstrates self-direction and motivation toward completion of various initiatives and acts as a coach to department staff.

Job Description

DUTIES/RESPONSIBILITIES – what you will be doing (top five):

• Overall program ownership and management key programs, focusing on both short-term initiatives and long-term strategic direction and objectives for the programs.
  • Management/oversight of program managers and cross-functional programs, processes, and workflows within Point32Health that support and service the programs and key initiatives;
  • Proactive and solutions-oriented management of program operations and integration issues, requiring the ability conceptualize and envision the impact of change, and propose new ways to do business to better meet the needs of the internal department and external stakeholders.
• Highest level program manager for projects applying project management expertise to ensure that workflows, processes, risks, communications, resources, and quality are managed appropriately within Point32Health to support programs and projects, at various levels (for example, business and regulatory levels).
  • Determines needs and defines, plans, and directs implementation plan;
  • Identifies risk within the context of the broad project and accurately estimates and plans resource usage accordingly;
  • Ensures that Point32Health’s established project management tools, processes, standards, and techniques are followed;
  • Oversees department staff contributing to highly critical projects;
  • Exercises judgment to make decisions, or to raise issues to the appropriate level in a timely manner;
  • Evaluates the cost and feasibility of multiple options/alternatives to resolve project issues and to make recommendations on those issues that best meet both program and corporate Point32Health objectives;
  • Manages project communications and interface with internal and external constituents to ensure that the program and project goals are met.
• Lead work effort to implement strategic and business initiatives.
  • Develop, coach, and retain high-performance project management staff;
  • Oversee staff to develop processes and systems to ensure high quality, consistent project management to ensure programmatic excellence;
  • Monitor, control, report, and present status of all elements of program and budgets;
  • Coach and mentor department staff to reinforce existing synergies and forge new working relationships across the company.
• Other duties and projects as assigned.

QUALIFICATIONS – what you need to perform the job

Certification and Licensure

Education

• Required: bachelor’s degree
• Preferred: master’s degree

Experience

• Required: (minimum) 5-7 years of professional experience
• Preferred: 10 or more years’ business or industry experience. 8 + years of program management experience, including leading the most cross -functional high-level initiatives.