OH Market Program Management Director – Preferred Experience in Managed Care

This is a fully remote position, open to applicants in Ohio.

📋 Description

• Support the Vice President of Duals Products in overseeing program implementations, ensuring compliance, monitoring operational performance, promoting program growth, and enhancing clinical and care management effectiveness, as well as developing pipelines for Quality and Affordability Initiatives and other program management activities.

• Direct Duals Program Management Operational functions across the OH Market from the perspectives of Program Management and Business Analysis.

• Develop strategies and objectives aimed at identifying and mitigating program risks.

• Recognize and facilitate the swift resolution or escalation of program-related issues, obstacles, and challenges.

• Assess the effectiveness of market-specific operational processes and manage process improvement initiatives in collaboration with Enterprise, Duals, and Market Teams.

• Embed continuous improvement and innovation into projects and initiatives.

• Formulate, articulate, and implement key strategies for functional and operational requirements.

• Utilize industry standards, best practices, project management tools, and techniques to support market initiatives.

• Oversee operational dependencies and risks across the Duals product initiative portfolio using change and risk management controls.

• Ensure the delivery of high-quality, consistent initiatives for OH members, providers, and program objectives.

• Monitor performance across market Duals programs to capitalize on best practices and knowledge sharing, aiming to enhance outcomes.

• Evaluate and manage program scope, schedule, and budget change impacts.

• Collaborate with business executives to align programs with business strategy, ensuring appropriate funding, resource allocation, and management.

• Foster cross-functional communication among impacted business and IT areas.

• Lead stakeholder meetings and represent programs in governance discussions.

• Review and sanction program meeting minutes.

• Cultivate working relationships with Integrated Dual Programs, market, and enterprise operations partners.

• Involve stakeholders to guarantee alignment.

• Provide leadership and support for product expansion initiatives.

• Undertake additional job-related responsibilities as required.

⛳️ Requirements

• A Bachelor's degree in project management, business, public health, or a related field is required.

• A Master's degree is preferred.

• Equivalent years of relevant work experience may be accepted in lieu of the required education.

• A minimum of six (6) years of experience in government-regulated (Federal and/or State) health insurance products, including Medicare, Medicaid, Managed Care Waiver, and FFS is required.

• At least six (6) years of experience in project and program management is required.

• Five (5) years of experience in driving performance and process improvements in the healthcare insurance sector is mandatory.

• Proven experience in implementing programs with a focus on integration is required.

• Strong background in the healthcare payer industry, including in-depth knowledge of Medicaid, Medicare, and government-regulated products.

• Comprehensive operational understanding across member and provider functions, clinical operations, and sales/business development.

• Profound knowledge of project management processes, tools, techniques, development lifecycles, and project management software.

• Capability to manage large, complex projects from inception to completion, including budgets exceeding $10M+, cross-functional teams, core members, and multiple vendors.

• Exceptional organizational, time management, prioritization, and execution skills.

• Outstanding analytical, reporting, decision-making, problem-solving, critical thinking, and active listening skills.

• Ability to identify business challenges, evaluate solutions, shape strategies, gain consensus, and comprehend the needs of business partners and stakeholders.

• Excellent written and verbal communication skills.

• Strong relationship-building, interpersonal, leadership, training, teaching, and change management skills.

• Ability to work independently while keeping market leadership and key stakeholders informed.

• Business acumen, political awareness, customer service orientation, and the ability to act with diplomacy and sensitivity to cultural diversity.

• Proficient with Microsoft Office tools, including Copilot AI, Project, Outlook, Word, PowerPoint, and Excel.

• Capacity to think strategically, lead proactively and efficiently, and demonstrate a sense of urgency.

• No licensure or certification is required.

• General office environment; may be required to sit or stand for extended periods.

• Flexible hours, including potential evenings and/or weekends as needed to serve members.

🏝️ Benefits

• Bonus opportunities tied to company and individual performance may be available.

• A comprehensive total rewards package.

• Flexible hours, including potential evenings and/or weekends as needed.

• Travel is not typically required.