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Job Description

• Effectively manage programs by setting clear milestones and deliverables, clearly communicating goals, objectives and responsibilities, keeping the programs focused in terms of deliverable management and meeting targeted time lines. Set and continually manage program expectations with team members and other stakeholders. Effectively communicate program expectations to Healthfirst and vendor stakeholders in a timely and clear fashion.

• Act as primary point person for delegated vendor oversight activities. This includes managing regular QA processes related to communications sent on Healthfirst's behalf to member and providers, as well as facilitating scheduled or ad hoc audits done by Healthfirst or other external experts. Develop and maintain Healthfirst policies and procedures related to vendor oversight.

• Develop and track measures showing vendor effectiveness and quality results. Share these results with the vendor and relevant Healthfirst stakeholders on a regular basis. Identify areas in need of improvement and work with stakeholders to propose solutions.

• Assist in managing contract renewals or other contract negotiations. Support Legal, Finance, and relevant business areas to ensure a smooth negotiation and implementation process.

• Assist in developing and managing the budget and product line allocations for vendor(s) on an annual basis. Assist in tracking expenses vs budget monthly.

Minimum Qualifications:

• Must have a bachelors degree from an accredited institution.

• Experience with Risk Adjustment Methodologies (CMS-HCC, HHS-HCC, CDPS, 3M CRG) or Value based healthcare methodologies.

• Analytical work experience within the healthcare industry. with competencies in SQL script development and expert proficiency in MS Excel (Pivot Tables, Advanced Formulas)

• Able to present information to senior and executive leadership on the progress of activities related to risk score accuracy.

• Accountable to executive sponsors for schedule, budget, and quality of all program elements

• Able to provide project management for managing projects across multiple departments.

Preferred Qualifications:

• Prior experience within the healthcare industry specifically supporting hospitals, vendor or payer networks is a plus.

• Development Experience in Data Visualization Platforms (i.e. Tableau, Power BI).

WE ARE AN EQUAL OPPORTUNITY EMPLOYER. Applicants and employees are considered for positions and are evaluated without regard to mental or physical disability, race, color, religion, gender, gender identity, sexual orientation, national origin, age, genetic information, military or veteran status, marital status, mental or physical disability or any other protected Federal, State/Province or Local status unrelated to the performance of the work involved.