Medicaid Fee-For-Service Operations Manager (Program Manager III)
MedImpact Healthcare Systems, Inc.
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Benefits offered by this job
Job summary
MedImpact Healthcare Systems, Inc. seeks a Program Manager III to lead strategic programs within Government Programs & Services and PDP, focused on Columbia, SC. You will analyze requirements, plan roadmaps, and deliver updates for complex programs, coordinating diverse teams and ensuring regulatory compliance.
The role emphasizes client communications, project planning, and successful execution of initiatives in a regulated healthcare environment. PMP or similar certification is desirable.
Qualifications
- This role requires a BS/BA and 9+ years of experience, with SME depth in respective areas.
- Advanced knowledge of Microsoft Office, MS Project and Visio.
- Experience gathering requirements and managing large projects.
Responsibilities
- Drives strategy and roadmap development for assigned programs.
- Manages scope, planning, requirements, and software updates.
- Coordinates multi-disciplinary teams and ensures regulatory compliance.
- Defines metrics and mentors junior program staff.
Skills
Education
Tools
Job description
$102,260 - $140,608 - $178,955
“Pay scale information is not necessarily reflective of actual compensation that may be earned, nor a promise of any specific pay for any selected candidate or employee, which is always dependent on actual experience, education, qualifications, and other factors. A full review of our comprehensive pay and benefits will be discussed at the offer stage with the selected candidate.”
This position is not eligible for Sponsorship.
MedImpact Healthcare Systems, Inc. is looking for extraordinary people to join our team!
Why join MedImpact? Because our success is dependent on you; innovative professionals with top notch skills who thrive on opportunity, high performance, and teamwork. We look for individuals who want to work on a team that cares about making a difference in the value of healthcare.
At MedImpact, we deliver leading edge pharmaceutical and technology related solutions that dramatically improve the value of health care. We provide superior outcomes to those we serve through innovative products, systems, and services that provide transparency and promote choice in decision making. Our vision is to set the standard in providing solutions that optimize satisfaction, service, cost, and quality in the healthcare industry. We are the premier Pharmacy Benefits Management solution!
This position works within the State of South Carolina, preferably in the area of Columbia, SC.
This position is contingent upon MedImpact's successful award and/or implementation of new business. Employment in this role is dependent upon the final business award, client approval (if applicable), and organizational staffing requirements. MedImpact reserves the right to modify or withdraw this opportunity based on business needs.
The Program Manager III works in one of three areas: Value Based Care (VBC), Government Programs & Services or PDP (MedGenerations) and is responsible for analyzing, creating new requirements, planning, and delivering updates for assigned programs and related services.
For GPS & MedGenerations specifically, the Program Manager works within one or more regulated market lines of business – Medicare Part D, Marketplace, Prescription Drug Plan (PDP) or the Medicaid plans including: Medicaid Fee for Services (FFS), Medicaid Managed Care (MMCO), Children’s Health Insurance Plan (CHIP).
Other duties may be assigned.
- Drives the development of the overall strategy and roadmap, research, requirements, and coordination for assigned programs.
- Follows outlined program management processes to manage the overall scope, planning, business requirements, implementation and delivery of software updates and other related requirements to assigned programs. Ensures business requirements are properly translated into customer deliverables. Schedules product release timelines with IT department. Coordinates product development schedules and releases to production.
- Drives appropriate work process improvement activities.
- New Products: Defines and documents business requirements for new products or services, through market analysis or other innovation strategy. Interfaces with end-users and business analysts to define business rules as they apply to processes and procedures; documents business requirements and develops work- flow diagrams, functional hierarchies, process models, revenue models and fee schedules. Prepares program development objectives and schedules all phases of program development and introduction to clients. Schedules product release timelines with the IT department. Coordinates technical product development and releases to production.
- Keeps current with and reviews state and/or federal requirements and regulations related to assigned programs to ensure that programs support client regulatory compliance.
- Provides day-to-day management and coordination of deliverables, issue tracking, and compliance issues for assigned programs. Ensures timely delivery of reports. Communicates to both internal and external clients on status, schedules, and changes.
- Coordinates the efforts of multi-disciplinary teams throughout various stages of the program development life-cycle. Manages large-scale, strategic, complex projects from start to finish and effectively leads project teams comprised of multiple business units.
- Develops client communications as needed to explain MedImpact response and/or changes in client responsibilities (related to drug benefit management). Attends client calls as needed to understand and address questions or issues for assigned programs.
- Maintains documentation for assigned programs including: Program Descriptions, Report Guides, Policies, Procedures, Work Instructions, training materials, etc.
- Serves as an expert resource for the line of business or for Government Programs and Services the focus will be on at least one regulated market, in addition to being a subject matter expert in assigned programs. Educates clients on program features. Provides expertise and training to other departments.
- Mentors less experienced program management team members and aids in cross training.
- Defines metrics to effectively measure the success of program and service processes and deliverables.
- Vendor oversight: if applicable for owned programs and services, monitors vendor operations, ensures appropriate metrics and PG’s are in place, and coordinates vendor changes as appropriate with MedImpact automation and/or work processes.
No supervisory responsibilities.
This is an internal and external client facing position that requires excellent customer service skills and interpersonal communication skills (listening/verbal/written). One must be able to; manage difficult or emotional client situations; Respond promptly to client needs; Solicit client feedback to improve service; Respond to requests for service and assistance from clients; Meet commitments to clients.
To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
BS/BA and 9+ years’ experience or equivalent combination of education and experience, and 6 years' of SME in respective areas
- Advanced knowledge of Microsoft Office software (Outlook, Word, Excel and PowerPoint)
- Advanced knowledge of MS Project and Visio
- Intermediate knowledge of at least one content management system (e.g. SharePoint, Confluence, wiki)
- Demonstrated ability to learn new software tools
- SQL query development
- Golden32 or other equivalent database browsing software
- Excel macro programming
PMP or other project management certification, desired, but not required.
- Excellent communication skills (written/verbal).
- Proven ability to plan and facilitate effective meetings.
- Skilled at business requirements gathering and ability to prepare and maintain detailed project plans
- Ability to manage multiple projects simultaneously and prioritize competing demands.
- Advanced presentation skills with the ability to present information at varying levels of abstraction depending on audience
- Good organization skills and attention to detail.
- Basic process improvement skills (e.g. tools and practices from agile, lean, six sigma)
- Basic to intermediate product management skills
- Strong problem-solving skills to handle: (1) problems that span a single area (2) problems that span multiple areas, and (3) facilitate across functional teams in developing solutions.
- Ability to effectively lead and influence cross-functional as well as virtual teams including remote participants.
- Ability to apply common sense understanding to carry out instructions furnished in written, oral, or diagram form. Ability to deal with problems involving several concrete variables in standardized situations.
- Ability to add, subtract, multiply, and divide in all units of measure, using whole numbers, common fractions, and decimals. Ability to compute rate, ratio, and percent and to draw and interpret bar graphs.
- Ability to read and interpret documents such as safety rules, operating and maintenance instructions, and procedure manuals.
- Ability to write routine reports and correspondence. Ability to speak effectively before groups of customers or employees of organization.
- Composure
- Decision Quality
- Organizational Agility
- Problem Solving
- Customer Focus
- Drive for Results
- Peer Relations
- Time Management
- Dealing with Ambiguity
- Learning on the FlyPolitical Savvy
The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. While performing the duties of this Job, the employee is regularly required to sit and talk or hear. The employee is regularly required to stand; walk; use hands to finger, handle, or feel and reach with hands and arms. The employee must occasionally lift and/or move up to 25 pounds.
The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. This position may regularly be exposed to or encounter moving mechanical parts, high, precarious places, fumes or airborne particles, toxic or caustic chemicals, outdoor weather conditions, risk of electrical shock or vibration. The noise level in the work environment is usually moderate (examples: business office with computers and printers, light traffic).
This position works within the State of South Carolina, preferably in the area of Columbia, SC. Must provide adequate support to internal clients; be available for regular interactions and coordination of work with other employees, colleagues, clients, or vendors; as well as be available to facilitate effective decisions through collaboration with stakeholders.
This is an exempt level position requiring the incumbent to work the hours required to fully accomplish job responsibilities and reasonable meet deadlines for work deliverables. The individual must have the flexibility to work beyond traditional hours and be able to work nights, weekends or on holidays as required. Work hours may be changed from time to time to meet the needs of the business. Typical core business hours are Monday through Friday from 8:00am to 5:00pm.
This position may require domestic travel.
- Medical / Dental / Vision / Wellness Programs
- Paid Time Off / Company Paid Holidays
- Incentive Compensation
- 401K with Company match
- Life and Disability Insurance
- Tuition Reimbursement
- Employee Referral Bonus
MedImpact, is a privately-held pharmacy benefit manager (PBM) headquartered in San Diego, California. Our solutions and services positively influence healthcare outcomes and expenditures, improving the position of our clients in the market. MedImpact offers high-value solutions to payers, providers and consumers of healthcare in the U.S. and foreign markets.
Equal Opportunity Employer, Male/Female/Disabilities/Veterans
To perform this job successfully, the successful candidate must be able to perform each essential duty satisfactorily. The requirements listed are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
The above statements are intended to describe the general nature and level of work being performed by people assigned to this classification. They are not intended to be construed as an exhaustive list of all responsibilities, duties, and skills required of personnel so classified.
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