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Sr Care Partner Program Manager - Remote, United States - Florida Blue
Description
What is Your Impact:
The Care Partner Program Manager is accountable for managing Care Partner Relationships. The key responsibilities include oversight of Care Partner vendor program performance and relationships as well as integration of activities across companies (external and internal), and resolution of issues and/or implementation of technical and process improvements to deliver efficient and effective Integrated Care Partner solutions and best in class member experience. The (CPPM) also focuses on developing a program's objectives and strategy and assessing how it will impact the department and other organizations within Florida Blue as well as our members. For each vendor, they will define and oversee the benchmarks needed to reach their targeted goals. Program Manager will be accountable for assessing current and future programs based on market needs. The program manager will implement strategic tasks that align suppliers/vendor programs(relationships) with the department's business strategy and goals, demonstrating high levels of coordination, delegation, and more.
This specific position will support Care Programs for the ASO/MPP segment.
What are your responsibilities:
Contract Management, Performance Management & Reporting:
• Responsible for program performance, including but not limited to the Care Partner's adherence to established SLA's, ROI, cross functional processes, etc.
• Contribute to the development and maintenance of Care Partner program performance scorecards
• Coordinate regular Care Partner meetings with internal business partners to facilitate sharing and monitoring operational performance, service level agreements, compliance, and process improvement opportunities
Contract and Compliance Management:
• Work with manager to support contract negotiations, contract amendments, and other contract activities
• Work with manager to support Integrated Care Partner compliance with corporate, legal, and regulatory requirements. Identify required business needs for contracting such as SLA's, Key Performance Metrics, Reporting's needs, etc.
Strategy Development, Integration and Execution:
• Facilitate one to two care partner deep dive strategy/roadmap meetings a year with critical internal partners included to understand the care partner's strategy and alignment to Florid Blue strategy and roadmap initiatives.
• Translate corporate strategies into tactical application for care partner program management.
Program Management
• Accountable for ensuring program performance per contract terms and developing renewal strategy to ensure company remains advantaged.
• Manage program financials again budget target. Asses financial risk and make recommendations against those risks.
• Identify market segments in which the company will participate by conducting primary and secondary market research.
Operational Support/Issue Management:
• Act as a liaison with external and internal business partners for issues resolution
• Work collaboratively with other areas to address process issues or program enhancements
Regulatory Compliance:
• Ensure care partner completion of corporate compliance requirements, training and annual due diligence requirements (i.e. FWA, VSA, licensure, annual questionnaire).
• Participate in ongoing audits of delegated functions to ensure compliance with CMS and NCQA requirements. Assist with and monitor Compliance or Internal Audit corrective action plans.
What is Required:
6+ years related work experience defined as working with ASO group and/or Account Management experience
Related bachelor's degree or additional related equivalent work experience
Experience delivering presentations to executive leadership
Experience building presentations
Experience developing sales tools and resources related to the care programs
Prior experience in supporting Request for Proposal (RFP) work
Experience working with continuous improvement in relationship with care program(s)
Ability to interact (with positive results) with a broad spectrum of internal and external individuals and departments
Travel (including overnight)
Additional Preferred Qualifications:
Project Management experience managing healthcare related projects
Working knowledge of Delivery System and Corporate strategy and vision
Delivery System experience (Medical Cost Management, Network, Care Management or DS Analytics)
General Physical Demands
Sedentary work: Exerting up to 10 pounds of force occasionally to move objects. Jobs are sedentary if traversing activities are required only occasionally.
What We Offer:
As a Florida Blue employee, you will thrive in our Be Well, Work Well, GuideWell culture where being well as an individual, and working well as a team, are both important in serving our members and communities.
To support your wellbeing, comprehensive benefits are offered. As an employee, you will have access to:
• Medical, dental, vision, life and global travel health insurance;
• Income protection benefits: life insurance, Short- and long-term disability programs;
• Leave programs to support personal circumstances;
• Retirement Savings Plan includes employer contribution and employer match;
• Paid time off, volunteer time off, 10 holidays and two flexible Well-Being days
• Additional voluntary benefits available; and
• A comprehensive wellness program
Employee benefits are designed to align with federal and state employment laws. Benefits may vary based on the state in which work is performed. Benefits for intern, part-time and seasonal employees may differ.
To support your financial wellbeing, we offer competitive pay as well as opportunities for incentive or commission compensation. We also conduct regular annual reviews with pay for performance considerations for base pay increases.
Annualized Salary Range: $96,000 - $156,000
Typical Annualized Hiring Range: $96,000 - $120,000
Final pay will be determined with consideration of market competitiveness, internal equity, and the job-related knowledge, skills, training, and experience you bring.
We are an Equal Opportunity/Protected Veteran/Disabled Employer committed to creating a diverse, inclusive, and equitable culture for our employees and communities.
