Senior Program Manager, Provider Reporting Insights and Analytics
Company: Cambia Health Solutions, Inc
Location: Portland
Posted on: April 17, 2024
Job Description:
Senior Program Manager, Provider Reporting Insights and
AnalyticsRemote opportunity for residents of Oregon, Washington,
Idaho and UtahPrimary Job PurposeThe 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
RequirementsCompetencies 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.
Keywords: Cambia Health Solutions, Inc, Vancouver , Senior Program Manager, Provider Reporting Insights and Analytics, Advertising , Portland, Washington
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