Program Manager II at Tufts Health Plan in Watertown, Massachusetts

Job Description:

We enjoy the important work we do every day on behalf of our members.

Job Summary

Under direction of the Manager, Employer and Vendor Programs, the Program Manager II partners with internal and external Stakeholders to assess, implement, and oversee complex requests, initiatives, and projects within assigned programs. The Program Manager II will perform thorough timeline and impact analysis, lead implementations that affect multiple departments, monitor and measure for project success, and will manage the governance of assigned programs. The Program Manager II should apply Tufts Health Plan policies in a consistent manner to ensure accurate cross functional operations and processing. The Program Manager II should be able to proactively identify and resolve roadblocks to ensure success and completions of projects. The Program Manager II will facilitate cross-departmental meetings as well as discussions with outside contacts (e.g. brokers, employer groups, and vendors) to explain and quantify the impact, options, and risks associated with custom requests.

Job Description

KEY RESPONSIBILITIES/ESSENTIAL FUNCTIONS*

Overall program ownership and management, focusing on both short-term initiatives and long-term strategic objectives.

Strategic Support

• Support leadership in setting strategic direction, support facilitation of decision making in regards to HRA/HSA/TPA products and relationships.

Program Management and Governance:

• Create, maintain and oversee Enterprise Program management, and governance models




• Provide overall relationship management. Contact for key issues, escalation, and facilitating joint decision making




• Monitor compliance with contractual operational performance and reporting requirements




• Create, maintain and oversee Enterprise Program management, and governance models




• Serve as the centralized point of contact for program related projects, issue resolution and facilitating decision making




• Collaborate with and support all operational areas on issue escalation, decision making, timely resolution and process/work flow improvements




• Ensure effective THP communication and issue resolution between stakeholders/owners




• Lead regular cross functional informational or working meetings, including effective agenda planning, facilitation, and tracking/follow up on deliverables until closed.




• Manage Issue resolution (e.g. coordinate research Re: why claims and eligibility feeds), proactively manage/remind Sales of upcoming renewals, de-escalating situations when incorrect information




• Ensure enterprise-wide needs for due diligence, risk assessment and continuing vendor monitoring are being accomplished




• Identify improvement areas internally as well as perform closely with all internal and external stakeholders to prepare solutions




• Develop and support processes to track, measure, report and evaluate vendor performance




• Troubleshoot all vendor problems and present to management as required




• Proactive, solution-oriented management of program operations and integration issues. Ability to conceptualize, envision and communicate the impact of change. Proposes new solutions to better meet the needs of both the client and THP

Special Projects:

• Participates in and/or leads initiatives within Enterprise Business Implementation department, as assigned.

Requirements

Qualifications:

• Bachelor's Degree required, with 6-8 years of progressive experience, preferably in program/project management, or a healthcare operations setting.




• Extensive experience leading cross-functional teams on high-level or departmental initiatives.




• Experience working with Sales, Client Services, employer group clients or brokers.




• Proven ability to lead successful projects/initiatives through to completion, and deliver quality outcomes.




• Proficiency with MS Office applications (Word, Excel, PowerPoint)




• Experience with project management tools (e.g. MS Project) with established track record of successful implementation aligned to originally outlined project objectives.

Skill Requirements

• Ability to lead and manage multiple projects/implementations simultaneously, balancing competing priorities.




• Ability to assess and communicate impact of custom client requests across multiple internal departments.




• Strong interpersonal skills with a desire to understand and serve unique, high-profile, and complex needs of clients while balancing the needs and goals of the organization.




• Excels in a fast-paced, changing environment.




• Ability to navigate difficult situations with effective leadership skills and professionalism.

• Highly developed oral and written communication skills. Strong influencing and advocacy skills, ability to lead others both internally and externally to ensure the success of the implementation or initiative.




• Highest level presentation skills including ability to interface and "sell" new programs and changes to existing programs to a broad range of internal and external clients.




• Possess strong influencing skills with the ability to manage and motivate cross-functional teams. Demonstrated ability to obtain the confidence and trust of non-reports, resulting in high commitment and cooperation.




• Requires the ability to maintain effective and productive peer relationships. Must have the ability to motivate fellow employees by fostering team spirit, an attitude of cooperation, and a commitment to the organization. Requires well-developed interpersonal skills to act in the capacity of liaison to the user community.

• Use/rely on best practices and lessons learned to create repeatable implementation strategies and make decisions that impact multiple business areas.




• Able to navigate and resolve sensitive and complex issues using advanced organizational knowledge to resolve roadblocks.




• Ability to advocate for all members of project team, while balancing client needs/requests and goals and objectives of THP.




• Able to identify key project risks, and create and share mitigation plans with project stakeholders and client.

• Ability to thrive in a matrix-management, hands-on environment that demands a consultative approach and solutions that span multiple business departments.




• Must be flexible and a proponent/champion of change. Able to conceptualize and envision the impact of change, and propose new ways to do business.




• Must be an accomplished multi-disciplinary team-leader and team-builder with hands-on style. Ability to lead teams whose members have diverse professional and educational backgrounds, and to effectively manage difficult group dynamics to effectively reach a positive outcome.

Confidential data:

• All information (written, verbal, electronic, etc.) that an employee encounters while working at THP is considered confidential. Will be exposed to and required to deal with highly confidential and sensitive material. Must adhere to corporate compliance policy, department guidelines/policies and all applicable laws and regulations at all times.

Working Conditions or Additional requirements (include special requirements, e.g., lifting, travel, overtime)

• Fast-paced office environment handling multiple demands. Moderate use of telephone and extensive use of PC required.




• Requires that the individual be organized while being readily adaptable to changes in work priorities. Flexible hours permitted providing the needs of the organization are met. May require occasional evening or weekend hours as the needs of the organization dictate. May require occasional client meetings.

What we build together changes our customer's health for the better. We are looking for talented and innovative people to join our team. Come join us!

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