Senior Program Manager, Provider Reporting Insights and Analytics

Senior Program Manager, Provider Reporting Insights and Analytics

Remote opportunity for residents of Oregon, Washington, Idaho and Utah

Primary Job Purpose

The Provider Reporting Insights and Analytics Sr. program Manager supports the implementation and sustainment of the PRIA reporting platform and associated programming developed internally or programs established through the vendor partnership.

Responsibilities include overseeing all aspects of daily Operational readiness and performance by managing and monitoring the digital products & services and the key functions including operating with excellence, program delivery, vendor management, direction, analytics & reporting, issue resolution while at the same time minimizing product financial risks. The PRIA Program Manager will deliver on operational success metrics (Service Level Agreements and Key Performance indicators), evoke actions to drive success, inform through business intelligence and deliver on financial stewardship outcomes.

The PRIA Program Manager provides support related to program evaluation, development, implementation, management of strategic direction, provider engagement, oversight and organization to ensure overall success of the product services, and works deeply and broadly in a cross-functional environment ensure the success of the product and programs as part of the holistic APM ecosystem.

Minimum Requirements

Competencies and Knowledge:

• Desire to work in fast-paced, multi-tasking, fluid environment with ever-changing priorities. Flexibility that allows effective teamwork with people at all levels of the organization.

• Ability to evaluate program effectiveness, identify issues and opportunities, and work to continuously improve programs offered. Ability to analyze financial measures associated with process improvement activities.

• Strong verbal and written communication skills, along with facilitation skills, including the ability to interpret and communicate clear and concise information, resolve issues with diplomacy and persuasiveness, and build consensus among groups of diverse stakeholders.

• Ability to track and analyze performance data and situations, learn quickly, and translate data into insights, recommendations for decision making and action plans.

• Experience in independently defining, developing, managing and reporting on processes and metrics.

• Ability to accomplish results through others by establishing relationships, effective controls and monitoring processes.

• Ability to partner effectively with external partners/vendors.

• Ability to coordinate cross-functionally to drive solutions and resolve issues in a timely and effective manner.

• Familiarity with contract language and understands and can identify contractual risk, with an ability to mitigate risk.

• Knowledge and familiarity with the health insurance industry trends, operations, technology and terminology.

• Strong communication skills and the ability to build and own relationships across the organization and with our vendor partners.

• General computer skills (including use of Microsoft Office, Outlook, internet search). Familiarity with health care and client management documentation systems, ideally Salesforce, is preferred.

Additional Minimum Requirements for Senior

• Strong organization and time management skills to plan, prioritize and execute several deliverables, simultaneously, within time constraints. Ability to think critically and make decision within individual role and responsibility.

• Deep understanding of Operational rigor, best practices and how to apply those methodologies to achieve a fact based, efficient focus on Operational performance and associated threats.

• Demonstrated experience in developing business processes, policies and procedures specific to operational and business readiness.

• Strong facilitation skills, including the ability to resolve issues and build consensus among groups of diverse stakeholders.

• Demonstrated ability to effectively handle major vendor performance issues with proper escalation and resolution

• Proven problem-solving skills with demonstrated ability to think out of the box and generate creative solutions. Ability to effectively translate issues to business impact and ensure that the appropriate sense of urgency is applied.

• Must have demonstrated experience in interfacing with multiple support disciplines and understand how to effectively lead and operate in a matrixed organization.

• Proven ability to effectively manage, report on and communicate service provider performance and delivery quality.

• Proficient at effectively managing multiple vendors with diverse vendor management and complex vendor deliverables

• Expert level analytical skills, with the ability to analyze complex data and situations, learn quickly and create options, recommendations and action plans.

• Demonstrated project and/or program management skills to manage large or multiple, semi-defined, projects with minimal supervision.

• Proven ability to interpret and communicate requirements, consumer data, bug fixes and client/customer needs with tact, diplomacy, patience, and professionalism.

• Skilled in effectively communicating with executive management.

• Strong MS Office (Excel focus) skills for product data analysis and communication.

• Demonstrated ability to transfer business requirements to written technical requirements.

Normally to be proficient in the competencies listed above:

Operations Program Manager Senior: Would have a bachelor's degree in business or health administration or related field and 8+ years of progressive experience in operational/business management, project/program management in healthcare, healthcare insurance operations or other large complex industries and/or vendor management or equivalent combination of education and experience. Experience managing/leading end-to-end projects/programs including program implementation in a healthcare setting and working with third part service providers is desired.

Project Management Professional (PMP) certification or equivalent work experience preferred.

General Functions and Outcomes

• Effectively collaborate with internal program leaders, senior management, and cross-functional managers/directors to develop program monitoring and assessment protocols for evaluation and improvement. Recommend program and process changes as appropriate.

• Effectively manage internal/external stakeholder relationships, ensuring the focused pursuit of desired outcomes.

• Prepares and presents operational objective plans and status reports to organizational leadership, project teams and client/customer groups when needed.

• Responsible for operational outcomes through effective project planning, task definition, scope management, resource allocation and negotiation, risk mitigation, cost management, and stakeholder communication.

• Escalates issues and works with team to mitigate issues and ensure timely resolution of problems within the scope of the assignment.

• Manages operational aspects of project, prepares and presents project status reports to organizational leadership, project teams and client/customer groups. Defines, collects and analyzes metrics to ensure projects are on target.

• Tracks all problem management resolution efforts to ensure that actions are being taken in agreed upon timelines, escalating to management when necessary. Validates all high severity issues have been prioritized accordingly and that appropriate teams are engaged for issues in question.

• Educate and train the leadership, staff, business associates and other stakeholders regarding new program elements, process and implementation.

• Maintain a system for ongoing data/statistical reporting and program assessment. Develop and communicate program documents, reporting, etc.

• In conjunction with internal operational leaders and/or vendor management, develops monitoring and control procedures.

• Maintains a system for ongoing data/statistical reporting and program assessment. Responsible for the development and maintenance of vendor program documents, reports, etc.

• Drives continuous improvement in all aspects of the vendor oversight process, including the evaluation of program outcomes.

• Establishes personal goals that align with the team/company mission and holds oneself accountable to those goals.

Additional General Functions and Outcomes for Senior

• Works with teams or customers to perform deep data driven analysis of business opportunities to surface actionable insights or requirements.

• Independently identifies opportunities, gaps, and process improvements.

• Facilitates and drives multiple projects; accountable for integrating with dependent projects and processes, oversees scope, risks and issues management, schedule, and budget.

• Assists leadership with problem identification and resolution, and program development by researching, assessing, and analyzing issues, and providing recommendations.

• Provides process improvement consultation, facilitation and management for targeted operational solutions including defining customer requirements, identifying systems improvements, and recommending actions.

• Assembles and leads cross-functional teams to address and resolve complex operations incidents or current performance.

• Responsible for project delivery and outcomes through effective operational planning, task definition, scope management, resource allocation and negotiation, risk mitigation, cost management, and stakeholder communication to successful completion; accountable for the quality and timeliness of all defined projects, and for issues within the projects.

• Acts as subject matter expert and drives process improvement throughout the organization to effectively benefit from the services provided by the vendor.

• Develop sustainable strategies for vendor performance management of vendors that include regular score-carding of performance, SLA monitoring, vendor business reviews, risk identification and management and identifying and implementing continuous improvement activities for each vendor managed.

• Develop focus area knowledge and expertise within the vendor management space to further understand company-wide needs and deliverables from vendors.

• Acts as a resource to other business owners and may mentor less experienced staff members.