Clinical Performance Program Manager, Transformation Management

| Remote
ABOUT THE ROLE
The Clinical Performance Program Manager, Transformation Management is responsible for leading, managing and successfully executing the installation, implementation and migration of systems and processes specific to the assigned functional domain.

YOUR RESPONSIBILITIES

  • Functional Domain Program Management:
  • Identifies and works with business SMEs at Bright Health to identify, understand, and translate business rules, processes, and business objectives to inform direction of transformation initiatives
  • Detailed understanding of current state functions, future state goals and translation between core and non-core systems
  • Fields requests from external teams and other Transformation Office teams to obtain detailed business information and secure commitments from SMEs on response times
  • Creates and/or explains templates and tools used to collaborate with other teams
  • Collaborates with business SMEs to set expectations of time commitments both in terms of level of effort and timing to minimize disruption to business-as-usual activities
  • Drives accountability with the business SMEs to provide inputs and sign-off on requirements, design, and acceptance criteria for implementations and migrations
  • Escalates risks and issues to Transformation Office Leadership
  • Partners with other Functional SME Leads within their team to drive cross-function solutioning
  • Collaborates with other Functional SME Leads within the team to coordinate joint sessions between functions needed to drive requirements gathering and sign-off activities
  • Works with Functional SME Leads in other Transformation Office teams when cross Line of Business solutioning and sign-off is required
  • Migration planning for current year and overall transformation plan from a people, process, and technology standpoint
  • Able to serve as a liaison between both business and technical teams to drive effective, timely solutions that fulfill both strategic and operational needs
  • Process Improvement:
  • Completes other assignments and initiative-based projects balancing company need, individual skill-set, and individual desire
  • Maintains HIPAA guidelines to ensure the confidentiality of all calls and documents

EDUCATION, TRAINING, AND PROFESSIONAL EXPERIENCE

  • Strong working knowledge of individual and Family plans required
  • Strong NCQA and URAC experience preferred
  • Strong working knowledge of Care Management and Utilization Management business processes, service level agreements, clinical vs. administrative roles and responsibilities and continuum of care within the care delivery workflow required
  • Familiarity with current systems and solutions used to manage CM/UM processes and procedures preferred
  • Demonstrated financial acumen, e.g., cost reduction, revenue growth, financial turnaround, etc. preferred
  • Four (4) years of experience with Utilization Management and/or Care Management/Coordination required
  • One (1) year exposure to clinical systems and/or clinical data analytics required
  • Bachelor’s degree preferred; Three (3) years of equivalent experience will be considered in lieu of degree
  • Three (3) years of healthcare experience required
  • Three (3) years of experience managing projects with demonstrated success required
  • Three (3) years of experience in a management/leadership role with demonstrated success required

PROFESSIONAL COMPETENCIES

  • Self-motivated
  • Thrives in a results-driven environment
  • Proficient with Microsoft Office Suite (Word, Excel, Power Point)
  • Proficient with Project Management tools
  • Effectively manage and balance priorities for self and team
  • Professional who properly handles confidential information
  • Ability to work well independently and in a team environment
  • Excellent written and verbal communication skills
  • Ability to positively handle/manage stress, such as high work volume and frequent change
  • Proven ability to think outside the box, optimize cross-functional processes and lead change
  • A blend of big-company business and process management experience, with the ability to translate needs to entrepreneurial/startup organizations
  • Outstanding client relationship, client facing and consulting skills. Able to juggle multiple priorities and know when to delegate, and when to take direct ownership
  • Comfortable presenting to senior executives
  • Experience or knowledge related to leveraging Social Determinants of Health data (SDOH) to drive care interventions

LICENSURES AND CERTIFICATIONS

  • RN certification preferred
  • PAHM Certification preferred
  • PMP Certification preferred

ABOUT US
 
At Bright Health, we brought together the brightest minds from the health care industry and consumer technology and together we created Bright Health: a new, brighter approach to healthcare, built for individuals. Our plans are easy to manage, personalized and more affordable, giving people the quality care they deserve. Through our exclusive care partnerships with leading health systems in local communities we are reshaping how people and physicians achieve better health together.
 
We’re Making Healthcare Right. Together. 
We've won some fun awards like: Great Places to Work, Modern Healthcare, Forbes, etc. But more than anything, we're a group of people who are really dedicated to our mission in healthcare. Come join our growing team!
 
As an Equal Opportunity Employer, we welcome and employ a diverse employee group committed to meeting the needs of Bright Health, our consumers, and the communities we serve. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law.
BRIGHT ON!

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Technology we use

  • Engineering
  • Product
  • Sales & Marketing
    • .NETLanguages
    • C#Languages
    • JavaLanguages
    • JavascriptLanguages
    • PythonLanguages
    • ScalaLanguages
    • SqlLanguages
    • PowerShellLanguages
    • D3JSLibraries
    • ReactLibraries
    • ReduxLibraries
    • FlutterLibraries
    • ExpressFrameworks
    • Node.jsFrameworks
    • MongoDBDatabases
    • MySQLDatabases
    • PostgreSQLDatabases
    • InVisionDesign
    • SketchDesign
    • Lucid ChartDesign
    • Aha!Management
    • ConfluenceManagement
    • JIRAManagement
    • Microsoft ProjectManagement
    • Microsoft DynamicsCRM

Location

We are downtown at 515 Congress Avenue, right in the heart of downtown! Tons of restaurants and close to public transportation.
Making Healthcare Better For All At Bright Health
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An Insider's view of Bright Health

What’s the vibe like in the office?

The office has a relaxed and laid back vibe but people are very serious about their work - perfect!

Anthony

Data Engineer

What does your typical day look like?

My day is so varied, given how quickly we're growing, which is fulfilling for me. I have a good balance of strategic and tactical work in my day as well as time to focus and time to collaborate.

Jen

VP, Digital

What makes someone successful on your team?

A hard-working team player who thinks first and codes next is likely to learn a lot and quickly become a valuable member of the team. Lots of experience with some of our tooling is always nice, but if someone can't knowledge-share well or responds poorly to code reviews and other requests for collaboration, it'll be a tough fit.

Brian

Software Engineer 3

How do your team's ideas influence the company's direction?

We hire smart individuals who thrive on accomplishment and purpose. Our teams are exposed to the bigger picture through constant communication and dialogues – that encourages them to come up with innovative solutions to problems. We've made significant adjustments on our direction in technology and process that were initiated by the team.

Abdullah

VP, Engineering

What are Bright Health Perks + Benefits

Bright Health Benefits Overview

We have 3 different health insurance plans, all through Cigna (HDP, Premium HDP and PPO). We cover the majority of the cost for the employee and some cost for family. We have two dental plans and a vision plan as well. We put 3% of your total earnings into your 401K plan and you are immediately vested in that. We have all the latest technology (Mac or Surface laptops – your choice) to use including standing desks. Fully stocked fridge with snacks and drinks.

Culture
Friends outside of work
Eat lunch together
Daily sync
Open door policy
Team owned deliverables
Team based strategic planning
Group brainstorming sessions
Pair programming
Open office floor plan
Diversity
Unconscious bias training
Mean gender pay gap below 10%
Diversity Employee Resource Groups
Hiring Practices that Promote Diversity
Health Insurance & Wellness Benefits
Flexible Spending Account (FSA)
Bright Health employees can contribute up to $3500 annually to their FSA.
Disability Insurance
Dental Benefits
Vision Benefits
Health Insurance Benefits
Life Insurance
Wellness Programs
Bright Health is proud to offer a wellness stipend of $200/month to all employees!
Onsite Gym
Mental Health Benefits
Retirement & Stock Options Benefits
401(K)
We will put 3% of your total earnings into your 401K plan, even if you don't put anything in. It's a safe harbor contribution.
401(K) Matching
Bright Health provides employees with a 401(k) plan managed by Vanguard. We provide a ‘safe harbor’ non-elective contribution equal to 3% of your compensation, regardless of participation in the p
Company Equity
Performance Bonus
Child Care & Parental Leave Benefits
Generous Parental Leave
We provide up to 6 weeks of parental leave for the primary caretaker. We also provide 2 weeks of leave for the secondary caretaker.
Flexible Work Schedule
Bright Health provides employees with a flexible work schedule that includes Core hours, Flexible start and end times.
Remote Work Program
Family Medical Leave
Company sponsored family events
Bright Health sponsors family oriented events Annually.
Vacation & Time Off Benefits
Generous PTO
Paid Holidays
Paid Sick Days
Perks & Discounts
Casual Dress
Commuter Benefits
Stocked Kitchen
Happy Hours
Happy hours are hosted on occasion.
Relocation Assistance
Fitness Subsidies
Bright Health employees are eligible for discounts on several gym memberships.
Home Office Stipend for Remote Employees
Professional Development Benefits
Diversity Program
Lunch and learns
Cross functional training encouraged
Promote from within
Online course subscriptions available
Customized development tracks

Additional Perks + Benefits

Bright's primary goal is to offer employee benefits and perks that are as flexible as possible to meet each employee's unique needs!

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