Senior Manager, Project Program Mgt (IC)

At CVS Health, we’re building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care.

As the nation’s leading health solutions company, we reach millions of Americans through our local presence, digital channels and more than 300,000 purpose-driven colleagues – caring for people where, when and how they choose in a way that is uniquely more connected, more convenient and more compassionate. And we do it all with heart, each and every day.

Position Summary
As a Senior Manager, you will be part of the Clinical Platform Solutions Interoperability team driving large enterprise business and system initiatives that focus on streamlining access and use of clinical data for our clinical staff. In this role, you will drive system projects and initiatives with emphasis on HEDIS bi-directional data exchange, clinical platform interoperability, technical enablement, and data acquisition, including Electronic Medical Record vendors, Health Information Exchange (HIE), Data Aggregators, and implementations of data ingest and egress pipelines. Furthermore, this role will have an affinity for collaboration, negotiation, and coordination among Information Technology (IT) teams and clinical/non-clinical operations within Utilization Management, Case Management, and Quality Management, driving towards strategic direction and objectives. Having a background in HEDIS as well as affinity towards technical concepts & build makes for an ideal candidate. Ability to work in a Hybrid Model (in office part-time during week) is preferred if reside near a HUB location.

Responsibilities include:

• Supports Business Development team with strong project management skills and technical knowledge of products and systems
• Manages significant product initiatives and cultivates relationships with internal and external constituencies.
• Directs, evaluates, and provides requirements/specifications for use of appropriate business processes and systems to support initiatives.
• Ensure the end state of initiatives and/or business constituent needs meets business objective(s) and that all deliverables and due dates are met
• Influence all partners to support key strategic direction to ensure positive outcomes that deliver on results
• Contribute to setting the strategic direction of the overall HEDIS & clinical platform interoperability roadmap/vision
• Identify gaps in processes or technology and challenges self and others to develop and implement solutions
• Drive change to improve systems/quality/services (for example policies, processes, or systems)
• Ensure effective communication of initiatives status to business partners and senior leadership
• Excellent verbal and written communications skills
• Provides leadership in negotiation and influencing sound business decisions based on data, results and information derived from industry trends, research findings, and Aetna-specific reports and analyses
• Manages projects, people, customer expectations and business priorities to achieve constituent satisfaction.
• Responsible for team commitments to quality and on-time deliverables.
• Participates on work groups/ forums representing HEDIS and Clinical platform interoperability needs.

Required Qualifications

• 5 years or more of managed care / health insurance experience
• Minimum 5 years of experience in Project Management and/or managing projects end to end
• Multiple years proven leadership experience setting strategic direction and influencing change that resulted in quantifiable positive outcomes.
• Strong organization skills and excellent verbal/written communications skills
• At least 2 years of Healthcare Effectiveness Data and Information Set (HEDIS) experience
• At least 1 year of experience utilizing Scaled Agile Framework (SAFe) methodology
• At least 1 year working with Health Information Technologies, EMR vendors (i.e., FHIR), cloud technology
• At least 1 year working in data analysis (SQL, Tableau etc.)
• Proven track record managing complex projects and or programs

Preferred Qualifications

• Advanced understanding of Health Information Exchanges (HIE’s) and Electronic Health Records (EHRs)
• In depth knowledge of Healthcare Effectiveness Data and Information Set (HEDIS) and National Committee for Quality Assurance (NCQA)
• 3 - 5 years working with Health Information Technologies (i.e., FHIR) cloud technology

Education

BS/BA or equivalent experience and 5 years of experience related to standards & measurements, technology, systems, and processes, inc