Who We Are

　　Point32Health is a leading health and wellbeing organization, delivering an ever-better personalized health care experience to everyone in our communities. At Point32Health, we are building on the quality, nonprofit heritage of our founding organizations, Tufts Health Plan and Harvard Pilgrim Health Care, where we leverage our experience and expertise to help people find their version of healthier living through a broad range of health plans and tools that make navigating health and wellbeing easier.

　　We enjoy the important work we do every day in service to our members, partners, colleagues and communities. To learn more about who we are at Point32Health, click here (https://youtu.be/S5I_HgoecJQ) .

　　Job Summary

　　The Senior Program Manager will be responsible for the management and oversight of complex programs and initiatives associated with the MassHealth Together Accountable Care and Managed Care Organization products offered by Point32Health, Tufts Health Plan, which are Medicaid health benefit plans funded/sponsored and regulated by the Massachusetts Executive Office of Health & Human Services (EOHHS). Internally, the senior manager coordinates and oversees day to day core processes associated with the MassHealth product life cycle, including supporting critical state contract amendments, implementation of required programs, benefits, and payment policies, compliance, reporting, and other programmatic and policy changes. Supports product leadership with Medicaid-related policy research, responses to product procurements, and special projects. Externally, the Senior Program Manager serves as the day to day program management key contact with EOHHS MassHealth program designees.

　　Reporting to the Director of MassHealth Policy & Program Administration, the Sr. Program Manager oversees key processes associated with ensuring successful execution of contractual requirements and appropriate product management and strategic plan across a highly matrixed organization and a broad set of external stakeholders. This role works closely with a cross-section of division and enterprise business and functional teams (operations, clinical services, network management, payment policy, legal, compliance, government affairs, marketing, community engagement, IT, etc.) to ensure appropriate product management and successful execution of contractual requirements.

　　The Senior Program Manager must be able to conceptualize and envision the impact of change and propose most effective ways to do business on behalf of the organization in a way that meets the regularity requirements and achieves the product strategic goals.

　　Key Responsibilities/Duties – what you will be doing

　　cts as assigned.Qualifications – what you need to perform the job

　　DUTIES/RESPONSIBILITIES

　　Manages MassHealth ACO and MCO program requirements and interface with internal and external constituents, including MassHealth and ACO Partners, ensuring that program goals are consistently met.

　　Serves as the day to day MassHealth product key contact with EOHHS MassHealth program designees. Responsible for analyzing, assessing, and internally disseminating MassHealth requirements and policy and programmatic communications, and in-turn, overseeing Point32health responsiveness to MassHealth, ensuring high quality, complete, and timely responses that best represent Point32Health mission and values.

　　Responsible, in partnership with other colleagues in the MassHealth Product Policy and Strategy team for managing relationships with MassHealth, ACO Partners, and other external stakeholders.

　　Collaborate, guide, and engage the appropriate level of business leaders and subject matter experts in internal and external discussions and meetings, implementing and resolving issues in a timely and responsible manner and building trust/credibility with MassHealth.

　　Ability to help translate MassHealth contractual and policy requirements into effective business solutions. Serve as subject matter expert to all enterprise functions when questions arise regarding MassHealth product contracts/programmatic/policy requirements, other applicable state and federal regulations and sub-regulatory guidance, benefit delivery, and other state programs and policies.

　　Oversee special projects relative to advancing the MassHealth product, including but not limited to supporting MassHealth Product team preparing responses to applicable state or federal procurements, the behavioral health reform roadmap, eligibility redeterminations policies, health equity policies, quality program, flexible services program, member escalations, etc.

　　Exercises judgment to make decisions, or to raise issues to the appropriate level in a timely manner.

　　Evaluates the cost and feasibility of multiple options/alternatives to resolve project issues and to make recommendations on those issues that best meet both program and corporate objectives;

　　Proactive and solutions-oriented management of program operations and integration issues, requiring the ability conceptualize and envision the impact of change, and propose new ways to do business to better meet the needs of the product, internal departments, and external stakeholders.

　　Other duties and projects as assigned.

　　QUALIFICATIONS

　　EDUCATION, CERTIFICATION AND LICENSURE:

　　Requires a Bachelor’s degree with a Master’s degree preferred.EXPERIENCE (minimum years required) :

　　8 or more years business or industry experience with an emphasis on health care, government health care products. 6 or more years of program management experience, including leading the most cross-functional high-level initiatives.

　　Significant business process and project management experience related to the implementation of healthcare insurance business applications and products using industry-standard project and program management tools and techniques with established track record.

　　A proven ability to meet deadlines is also required.

　　SKILL REQUIREMENTS:

　　Ability to thrive in a matrix-management, hands-on environment that demands a consultative approach and solutions that span multiple environments in a business area.

　　Outstanding communication and relationship management skills, including the ability to effectively manage group dynamics, influence others to effectively reach a positive outcome

　　Strong understanding of the managed care industry and familiarity in working with government-funded products or state and federal policy analysis

　　Exceptional project management and stakeholder management skills

　　Exceptional organizational and communication skills

　　Independent thinker and self-starter, be able to think creatively, take responsibility, be very resourceful, and have a high energy level

　　Must be able to work cooperatively as a team member. Strong negotiating, influencing, and advocacy skills, ability to lead others both internally and externally to ensure the success of the program.

　　Highly developed oral and written communication skills, ability to communicate with internal and external constituents at all levels with confidence.

　　Highest level presentation skills. Ability to interact with confidence with external and internal senior management.

　　Ability to balance strong leadership on day-to-day program management and significant issues while also aligning with program director’s broader needs and vision for the program.

　　Possess strong influencing and situational leadership skills with the ability to manage and motivate both direct and non-direct reports. Must have a demonstrated ability to obtain the confidence and trust of non-reports, resulting in high commitment and cooperation.

　　WORKING CONDITIONS AND ADDITIONAL REQUIREMENTS (include special requirements, e.g., lifting, travel) :

　　Must be able to work under normal office conditions and work from home as required.

　　Work may require simultaneous use of a telephone/headset and PC/keyboard and sitting for extended durations.

　　May be required to work additional hours beyond standard work schedule.

　　The above statements are intended to describe the general nature and level of work being performed by employees assigned to this classification. They are not intended to be construed as an exhaustive list of all responsibilities, duties and skills required of employees assigned to this position. Management retains the discretion to add to or change the duties of the position at any time.

　　Salary Range

　　120,539-155,991

　　Compensation & Total Rewards Overview

　　The annual base salary range provided for this position represents a broad range of salaries for this role and similar roles across the organization. The actual salary for this position will be determined by several factors, including the scope and complexity of the role; the skills, education, training, credentials, and experience of the candidate; equity with internal colleagues; and other conditions of employment. As part of our comprehensive total rewards program, colleagues are also eligible for variable pay. Eligibility for any bonus, commission, benefits, or any other form of compensation and benefits remains in the Company's sole discretion and may be modified at the Company’s sole discretion, consistent with the law.

　　Point32Health offers their Colleagues a competitive and comprehensive total rewards package which currently includes:

　　Medical, dental and vision coverage

　　Retirement plans

　　Paid time off

　　Employer-paid life and disability insurance with additional buy-up coverage options

　　Tuition program

　　Well-being benefits

　　Full suite of benefits to support career development, individual & family health, and financial health

　　For more details on our total rewards programs, visit https://www.point32health.org/careers/benefits/

　　Commitment to Diversity, Equity, Inclusion, Accessibility (DEIA) and Health Equity

　　​Point32Health is committed to making diversity, equity, inclusion, accessibility and health equity part of everything we do—from product design to the workforce driving that innovation. Our Diversity, Equity, Inclusion, Accessibility (DEIA) and Health Equity team's strategy is deeply connected to our core values and will evolve as the changing nature of work shifts. Programming, events, and an inclusion infrastructure play a role in how we spread cultural awareness, train people leaders on engaging with their teams and provide parameters on how to recruit and retain talented and dynamic talent. We welcome all applicants and qualified individuals, who will receive consideration for employment without regard to race, color, religion, gender, gender identity or expression, sexual orientation, national origin, genetics, disability, age, or veteran status.

　　At Point32Health, we strive to be a different kind of nonprofit health and well-being company, with a broad range of health plans, and innovative tools that make navigating health and well-being easier, guiding our members at every step of their health care journey to better health outcomes. We are committed to providing high-quality and affordable health care, improving the health and wellness of our members, and creating healthier communities across the country. The Point32Health name is inspired by the 32 points on a compass. It speaks to the critical role we play in guiding and empowering the people we serve to achieve healthier lives. Our employees are hard-working, innovative, and collaborative. They look for opportunities to grow and make a difference, and they help make us strive to be one of the Top Places to work in New England.