Director, Health Plan Partner Operations

Carrum Health; San Francisco (CA); Remote; USD 95,000 - 150,000; Full time

Job summary

An innovative health tech company is seeking a Director of Health Plan Partner Operations to lead the charge in transforming healthcare delivery. This pivotal role involves managing health plan partnerships, ensuring operational excellence, and driving strategic growth. You will collaborate closely with cross-functional teams to enhance member experiences and optimize healthcare solutions. Join a passionate team dedicated to making healthcare more affordable and consumer-centric, while working with top hospitals and employers. If you're ready to make a meaningful impact in the healthcare industry, this opportunity is for you.

Benefits

Stock option plan

Flexible schedules

Self-managed vacation days

Paid parental leave

Health, vision, and dental insurance

Qualifications

• 10+ years in healthcare project/product management and operations.
• Proven track record in managing complex health plan partnerships.

Responsibilities

• Oversee day-to-day operations for health plan partners.
• Drive project management and successful implementation of partnerships.

Skills

Healthcare Industry Experience

Project Management

Account Management

Operations Management

Communication Skills

Analytical Skills

Stakeholder Engagement

Problem Solving

Education

Bachelor's Degree

Master's Degree (Preferred)

Job description

Director, Health Plan Partner Operations

At Carrum, we are transforming how we pay for, deliver and experience healthcare. If you are passionate about changing healthcare and want to finally get rid of surprise bills, poor quality, and high prices, while thriving in an entrepreneurial, cutting-edge environment, we would love to connect with you.

In 2014 Carrum reinvented the Centers of Excellence (COE) category in digital health. Today, 95% of the US population lives within 50 miles of a Carrum COE and our providers rank in the top 10% nationally. Our team’s execution has been recognized by the venture community and we’ve raised more than $96M in aggregate from investors like OMERS, Tiger Global Management and Wildcat Ventures. Our impact has been externally proven in a 2021 RAND Corporation study and featured as a Harvard Business School (HBS) case study .

The role of Director, Health Plan Partner Operations will ensure smooth and scalable implementations, operations, and growth across our portfolio of healthcare ecosystem and health plan partners. You will implement new health plan partnerships, establish and maintain integrations and coordinated member experiences, and ensure operational excellence across billing, reporting, and contract management.

Reporting to the Vice President, Health Plan Partnerships, this is a highly visible role across the organization, working closely with our platform, patient care, growth, sales, client success, legal and finance teams to operationalize all aspects of our partnerships. You will drive the strategy, efficiency and growth for new and existing health plan partners to bring world-class, value-based care to millions of lives across the US.

You’re excited about this opportunity because you will...

• Serve as the day to day operations owner for Carrum’s health plan partners, building strong and lasting relationships based on mutual trust and aligned objectives
• Own the project management delivery and successful implementation of new health plan partnerships, as well as the expansion of existing partnerships
• Refine and iterate our health plan partner implementation infrastructure, including but not limited to implementation playbooks, data and analytics capabilities, reporting standards, and relationship health measurements
• Drive the measurement and tracking of bi-directional referrals between Carrum and our health plan partners
• Establish and analyze reporting data to extract insights and drive improvements to member engagement in an iterative fashion
• Quarterback technological integration with health plan partners to improve the utilization of Carrum’s solution and improve the member experience for those that pass between Carrum and our health plan partners
• Identify opportunities for Carrum’s product roadmap, define requirements, and collaborate on solution design with our Platform Team
• Serve as the quarterback by interfacing with health plan partners and Carrum’s Patient Care Team so both parties are set up for success in easily sending and receiving referrals
• Drive care coordination workflows by balancing multiple stakeholder needs
• Manage the financial aspects of our health plan partnerships including billing and invoicing, and revenue share calculation
• Serve as the liaison to Carrum’s Finance team to ensure accurate and timely payments with respect to our partnerships
• Manage the contractual aspects of our health plan partners including order forms for new employer clients adopting Carrum, and amendments to existing contracts as needed, interfacing with Carrum’s Legal/Contracting department where appropriate

We’re excited about you because…

• 10+ years of experience in the healthcare industry in health plan project/product management, account management, operations, and/or consulting roles
• Proven track record of managing and growing complex, high-value health plan partnerships, ideally within value-based care or digital health solutions.
• Exceptional communication, presentation, and organizational skills, with the ability to engage with and influence stakeholders across all levels, both internally and externally.
• Deep understanding of health plan / TPA operations, decision-making processes and strategic priorities.
• Highly detailed-oriented, extremely organized and results-driven; exceptional at creating process and structure. Strong operational and reporting prowess.
• Strong analytical skills and the ability to use data for storytelling and driving decision-making.
• Entrepreneurial spirit; not afraid of ambiguity, ability to innovate, think outside the box, and solve problems creatively and strategically
• Experience working in fast-paced environments with aggressive deadlines and cross-functional collaboration.
• Are self-motivated; a go-getter that proactively looks to make things better rather than waiting for marching orders
• Passion about Carrum Health’s mission to make healthcare more affordable and consumer-centric

Why you’ll love working with us...

• We’re a hard-working, humble, and compassionate group motivated to solve the hard problems in healthcare today. You’ll work with talented, experienced co-workers from companies like Booz & Company, Livongo, 98point6, Google, and Optum. We believe in using data to inform decisions, technology to make our jobs easier, and creative thinking to pave the future.
• We are working with some of the most recognized and esteemed names in the country. Top hospitals like Johns Hopkins, Mayo Clinic, Stanford Health Care, Scripps Health, and Rush Health have joined our platform. Employers who use our benefit include US Foods, United Airlines, and large public sector organizations like the self-insured schools of California, and the State of Maine.
• We empower team members to be autonomous and provide a collaborative environment where you get support and healthy feedback. You can bring your authentic self to work every day and are encouraged to help others do the same.
• We carve out time to let go of work to celebrate our successes and have fun. We’re a remote-first company with employees all over the United States and two office locations in San Francisco and Chicago. We support our employees during the work day and beyond with flexible working hours, generous time off, paid parental leave, and opportunities to connect with coworkers both virtually and in-person.
• We embrace our team’s diversity of thought, experience, and interests and know that doing so makes us stronger as a company. Carrum has an active employee-led Diversity, Equity, Inclusion, and Justice (DEIJ) committee and several employee resource groups (ERGs). Our ERGS help employees build stronger connections through social, educational, and community activities.
• You’ll feel proud that the work you do each day directly impacts people’s lives in big and meaningful ways.

Other benefits:

• Stock option plan
• Flexible schedules and remote work
• Chicago and San Francisco offices available
• Self-managed vacation days, within reason
• Paid parental leave
• Health, vision, and dental insurance

About Carrum

We’re a health tech company that brings value-based care to the masses. We help employers deliver a memorable patient experience, immediately lower healthcare costs, and drive better outcomes and achieve this through the power of technology and human-centered design. Since launching in 2014, we’ve partnered with Fortune 500 employers and top hospitals across the nation. We’ve been recognized by Harvard Business School and featured in TechCrunch, The Los Angeles Times, Washington Post, and Modern Healthcare. We believe we’re only scratching the surface of our opportunity and we’re looking for incredible people like you to help us realize our full impact.

Carrum Health is an equal opportunity employer and encourages all applicants from every background and life experience.

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