Program Lead, Payor Connections – Interoperability

This is a fully remote position, open to applicants in Arizona, +16 more states.

📋 Description

• Lead interoperability initiatives through provider outreach efforts.

• Cultivate partnerships with provider group associates and vendors.

• Develop and sustain project management plans.

• Assist in formulating operational strategies and market approaches.

• Collaborate across various teams to pinpoint actions needed for improvements and assess the impact of initiatives.

• Oversee the testing and validation of data connections to guarantee compliance and functionality.

• Manage the creation and upkeep of vital operational dashboards, updating and refining them as user requirements change.

• Monitor development progress, address issues related to data quality or integration, and ensure ongoing enhancements in interoperability programs.

• Act as a subject matter expert on TEFCA.

• Ensure adherence to all relevant laws and regulations.

• Execute additional responsibilities as assigned.

• Report directly to the Director of Risk Adjustment Retrospective.

⛳️ Requirements

• A minimum of 3 years of experience in healthcare operations or health insurance, working directly with provider groups.

• At least 2 years of experience in delivering interoperability projects or programs.

• Comprehensive knowledge of TEFCA.

• Strong analytical abilities.

• Experience in risk adjustment is a plus.

• Basic proficiency in SQL or BigQuery query writing is an advantage.

🏝️ Benefits

• Comprehensive employee benefits.

• Unlimited vacation policy.

• Annual performance-based bonuses.

• Medical coverage.

• Dental coverage.

• Vision coverage.

• 11 paid holidays.

• Paid sick leave.

• Paid parental leave.

• Participation in a 401(k) plan.

• Life insurance coverage.

• Disability insurance.

• Paid wellness time.

• Wellness reimbursements.