Join Martin's Point Health Care - an innovative, not-for-profit health care organization offering care and coverage to the people of Maine and beyond. As a joined force of "people caring for people," Martin's Point employees are on a mission to transform our health care system while creating a healthier community. Martin's Point employees enjoy an organizational culture of trust and respect, where our values - taking care of ourselves and others, continuous learning, helping each other, and having fun - are brought to life every day. Join us and find out for yourself why Martin's Point has been certified as a "Great Place to Work" since 2015.
Position Summary
The Director, Enterprise Applications, leads the Enterprise Applications organization, including Health Plan Applications (HPA), Enterprise Salesforce/Applications, Application Development, and Enterprise Architecture. The Director's first priority is to unify and transform the HPA teams into a single, integrated function with clear ownership of core system configuration and accuracy, including but not limited to claims, benefits, enrollment and care management systems. The Director provides strategic and operational leadership for the enterprise application portfolio, aligns application configuration, development and architecture with health plan business priorities and regulatory requirements, and ensures teams organize, prioritize and complete work with appropriate oversight controls, reporting and quality assurance in place.
PRIMARY DUTIES AND RESPONSIBILITIES
- Leads and transforms the Health Plan Applications (HPA) teams into a single, integrated function with clear IT and business ownership, defined roles, and a sustainable operating model for core system configuration
- Drives quality, timely system configuration and maintenance of core health plan systems (e.g., QNXT, care management, enrollment) to allow the health plan to achieve regulatory compliance, robust financial management and product strategy outcomes
- Oversees, develops, and maintains documentation for claims and benefit configuration processes and procedures with appropriate controls, reporting and quality assurance
- Develops robust testing protocols; supports regular audits and quality checks to ensure configuration accuracy, data accuracy and system performance
- Leads the Application Development team in the design, build, and support of custom applications and system integrations, applying Software Development Life Cycle (SDLC), DevOps and secure development standards
- Provides leadership for the Enterprise Salesforce/CRM platform, including platform ownership, administration, release management and applications support, in partnership with business stakeholders
- Partners with Enterprise Architecture to ensure application solutions align with enterprise standards, the technology roadmap, and integration and data strategies
- Develops work intake mechanisms across Enterprise Applications teams, exploring and implementing tools to manage inventory of tickets, prioritize backlog and assess different work types (i.e., reporting, configuration, development, project vs. production fixes, etc.)
- Delivers strong vendor oversight to optimize system processing to improve efficiency and accuracy; pursue new vendor opportunities including Request for Information (RFI)/Request for Proposal (RFP) as deemed appropriate
- Collaborates with business, Operations, Data & Analytics and IT teams to ensure system and operational readiness for system fixes, configuration, and project rollouts
- Collaborates with infrastructure and integration teams to ensure system upgrades, enhancements, integration updates and file loads are coordinated and implemented
- Manages the Enterprise Applications budget, staffing plan and vendor spend; tracks performance against key metrics and service levels
Employees are expected to work consistently to demonstrate the mission, vision, and core values of the organization.
POSITION QUALIFICATIONS
Education
- Bachelor's degree required
- Master's in Business Administration, Information Systems, or comparable advanced degree strongly preferred
Licensure/certification
- Project management (PMP), Agile/SAFe, ITIL, or Salesforce certification preferred
Experience
- 10+ years health plan or healthcare information technology experience, including 5+ years leading application, configuration, or development teams required
- Experience managing vended core system applications required
- Demonstrated experience leading organizational change and transforming team operating models required
- Experience with test plan development, strategy, and execution required
- Experience with Cognizant (TriZettu) QNXT configuration, administration, or implementation strongly preferred
- Experience leading application development teams (custom development, integrations, SDLC) preferred
- Familiarity with Salesforce or other CRM platforms preferred
- Experience supporting Medicare Advantag