Director, Enterprise Applications - Remote

Martin's Point Health Care; United States; À distance; USD 166 000 - 204 000; Plein temps

Résumé du poste

Martin's Point Health Care Inc. seeks a Director of Enterprise Applications to unify Health Plan Applications, align configuration, and lead development and CRM platforms. The role requires strong leadership, change management, and strategic collaboration with IT, operations, and analytics teams.

You will oversee core system configuration for claims, enrollment, and care management, ensuring regulatory compliance, budget stewardship, and high-quality system performance.

Qualifications

• Bachelor's degree required.
• Master's in Business Administration, Information Systems, or comparable advanced degree strongly preferred.
• Project management (PMP), Agile/SAFe, ITIL, or Salesforce certification preferred.
• 10+ years health plan or healthcare information technology experience, including 5+ years leading application, configuration, or development teams.
• Experience managing vended core system applications.
• Experience leading organizational change and transforming team operating models.
• Experience with test plan development, strategy, and execution.
• Experience with Cognizant (TriZetto) 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 Advantage and/or TRICARE lines of business preferred.

Responsabilités

• Lead HPA teams to a unified function with clear IT/business ownership and a sustainable operating model for core configuration.
• Ensure timely configuration and maintenance of core systems (QNXT, enrollment, care management) for compliance and financial outcomes.
• Oversee documentation for claims/benefit configuration with controls, reporting and QA.
• Develop testing protocols; support audits to ensure data/config accuracy.
• Lead Application Development for custom apps/integrations using SDLC, DevOps, and secure standards.
• Lead the Enterprise Salesforce/CRM platform with platform ownership and release management.
• Collaborate with Enterprise Architecture to align solutions with standards and roadmaps.
• Create work intake and backlog management to prioritize tickets.
• Oversee vendors; optimize system processing and explore new RFI/RFP opportunities.
• Collaborate with business, Ops, Data & Analytics and IT for readiness of fixes and rollouts.
• Coordinate with Infra/Integration teams for upgrades and integrations.
• Manage budget, staffing, vendor spend; track metrics and SLAs.

Connaissances

Leadership

Communication

Change management

Problem solving

Team collaboration

Formation

Bachelor's degree

Master's degree

Outils

Jira

ServiceNow

Azure DevOps

QNXT configuration

Salesforce

Description du poste

Position Summary

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. 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

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 (TriZetto) 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 Advantage and/or TRICARE lines of business preferred
• Knowledge:
  • Maintains knowledge and understanding of reimbursement agreements as well as claims and billing practices that impact cost and utilization data
  • Knowledge of industry standards for claims and enrollment configuration, reporting and analysis
  • Knowledge of benefit coverage and servicing members, providers, and the DoD, CMS/ Medicare Advantage, and ME state insurance coverage
  • Knowledge of managed care computer systems, features, and reporting
  • Knowledge of CMS interoperability requirements (e.g., CMS-0057-F) and healthcare data standards (HL7 FHIR, X12 EDI) preferred
  • Knowledge of Agile delivery practices and IT service management (ITSM) preferred
• Skills:
  • Excellent workflow and inventory management skills
  • Demonstrated interpersonal, communications, operational, team building, and quality improvement skills
  • Strong leadership, coaching and change management skills, with the ability to unify teams around shared goals
  • Ability to communicate effectively with executive leadership and translate business needs into technology solutions
  • Proficiency with work management and ticketing tools (e.g., Jira, ServiceNow, Azure DevOps) preferred
• Abilities:
  • Demonstrates an understanding of and alignment with Martin’s Point Values
  • Develops and maintains positive, effective working relationships with colleagues, vendors, and other internal and external customers
  • Excellent problem solving, quantitative and analytical skills with the ability to assess performance against metrics
  • In-depth technical knowledge and ability to learn new technologies; knowledge of the Software Development Life Cycle (SDLC)
  • Ability to manage, organize, and prioritize workload in a timely accurate manner.
  • Ability to manage multiple competing demands and function independently
  • Critical thinking: can identify root causes and implement short- and long-term sustainable solutions

In compliance with MPHC’s Department of Defense contract, all persons hired for this position will need to verify their U.S. citizenship and complete the required employment eligibility verification upon hire.

Pay Range:

Pay Range: $165,546.85 - $204,499.05 To promote pay equity, Martin’s Point Healthcare has established defined salary ranges for each role. Compensation is established within the posted range based on a variety of factors, including relevant years of experience, current market conditions, internal equity, and budget considerations. The pay range reflects the potential compensation for this role based on a full-time position. Employees may also be eligible for additional compensation, such as incentive or commission-based programs, where applicable and subject to the terms of the applicable plan. Final compensation is determined at the conclusion of the interview process. We encourage you to apply even if your desired compensation falls outside of the listed range.

Benefits:

• medical
• dental
• vision
• retirement savings with employer contributions
• paid time off (including volunteer time off!)
• pie day
• other employee benefits

This position is not eligible for immigration sponsorship.

We are an equal opportunity/affirmative action employer.

Martin's Point complies with federal and state disability laws and makes reasonable accommodations for applicants and employees with disabilities. If a reasonable accommodation is needed to participate in the job application or interview process, to perform essential job functions, and/or to receive other benefits and privileges of employment, please contact [e-mail]

Do you have a question about careers at Martin’s Point Health Care? Contact us at: [e-mail]

Martin’s Point Health Care is a progressive, not-for-profit organization providing care and coverage to the people of Maine and beyond. The organization operates six primary care health care centers in Maine and New Hampshire, accepting most major insurance plans. Martin’s Point also administers two health plans: Generations Advantage (Medicare Advantage plans available throughout Maine), and the US Family Health Plan (TRICARE Prime® plan for active-duty and retired military families in Maine, New Hampshire, Vermont, upstate New York, northern and western Pennsylvania, and northeastern and central Ohio). For more information, visit https://careers.martinspoint.org.