Program Manager, Federal Plan

2 weeks ago

Honolulu, United States HMSA Full time
  1. Program and Project Management:
    • Responsible for strategic and tactical planning of HMSA's approach to delivering excellent performance and value for Federal Plan 87 and providing clear leadership, training, guidance, and coordination to all HMSA and partner/vendor resources supporting Federal Plan 87.
    • Responsible for managing and cultivating HMSA's relationship with OPM, and training and mentoring other HMSA employees who must also communicate directly with OPM. Develops and promotes a collaborative partnership between HMSA and OPM through proactive, open, and honest communication that ensures strong mutual understanding, awareness, and support of shared priorities.
    • Responsible for all outgoing correspondence and communications with OPM and advising and coordinating all responses to OPM for any inquiries, issues, and/or requirements that arise.
    • Manages and provides direction on all internal requirements, regulatory, compliance requirements and initiatives related to benefits, contractual obligations, or any activity related to or affecting the Federal Plan.
  2. Annual Call Letter & Renewal:
    • Manages, leads, and is responsible for the efficient and effective management of the company-wide matrixed effort to both respond to the annual OPM Call Letter (Request for Proposal) and to meet all operational requirements once the contract is secured. This includes coordinating efforts among virtually every major function within the organization and with our partners/vendors.
    • Responsible for all activities related to the research, analysis, and coordination of required plan changes, benefit proposals and changes, rate and financial calculations and adjustments, Federal brochure revisions and updates, and impact to all internal departments.
    • Meets with senior executives and secures their approval of HMSA's bids and also any subsequent commitments and/or responses due to the government. Submits those documents to OPM for their review and approval and responds to any inquiries they may have. Works with appropriate areas including legal on the annual contract review/approval process.
    • Responsible for the accurate and timely implementation of all plan and benefit changes with all affected departments.
  3. Standard Reporting Management & Oversight:
    • Coordinates and oversees various contractual requirements for Federal Plan 87, such as the "Standard Reporting" requirements (HEDIS and NCQA requirements, Performance Standard reports, and Fraud and Abuse semiannual report).
  4. Performs all other miscellaneous responsibilities and duties as assigned or directed.
#LI-Hybrid

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