Program Manager – Govt Program Services/Medicaid

MedImpact Healthcare Systems - San Diego, CA3.3

Full-time
The Program Manager III is responsible for analyzing, creating new requirements, planning, and delivering updates for assigned programs and services.

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).

Essential Duties and Responsibilities include the following. 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 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 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.
Education and/or Experience

For consideration, candidates will need a Bachelor's degree (or equivalent combination of education and experience) along with at least seven (7) plus years’ related job experience. Prior experience must include project management and leadership responsibilities. Previous experience in the healthcare, pharmacy, or pharmaceutical industries is desirable but not required.

Computer Skills

To perform this job successfully, an individual should have:
  • 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
Skills that are desirable but not required:
  • SQL query development
  • Golden32 or other equivalent database browsing software
  • Excel macro programming
Certificates, Licenses, Registrations

PMP or other project management certification, desired, but not required.

Other Skills and Abilities
  • 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.
This position is eligible for Employee Referral Bonus at Level II

EOE, M/F/D/V

OSHA/ADA:

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.

Disclaimer:

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.