ABOUT THE ROLE
The Lead Implementation Manager – Medical Cost is a critical part of the Bright HealthCare Medical Cost Management team and is responsible for leading successful execution of high priority initiatives. The Manager will partner closely with the Medical Cost Consultants and key business area leaders to transform new ideas into executable opportunities across multiple markets, lines of business (Individual and Family Plans, Medicare Advantage, and Employer) and functional areas (Clinical, Network, Operations, Member and Provider Services, etc).
The successful candidate will be a self-starter and will have a proven track record of succeeding in fast-paced and complex health plan settings. You have a demonstrated ability to create comprehensive project plans to support timely and high quality execution. You excel at seeing both the “big picture” and also the detail necessary to ensure initiatives are being managed with high quality. You lead with accountability; are an excellent verbal and written communicator; operate with strong attention to detail. Your colleagues and clients recognize you for leading through influence, having empathy towards others, being highly collaborative and strongly exhibit the ability to drive towards measurable outcomes.
- Partner with the Medical Cost Consultant Team to review new MCM programs and complete enterprise impact assessments
- Create current state and future state process flows
- Develop requirements with detailed project and resource plans
- Drive execution of programs to ensure timelines are met and deliverables are signed off and complete
- Perform ad hoc data analysis to answer operational questions and/or to execute operational processes
- Manage and coordinate multiple projects across a matrixed environment including facilitation of meetings and follow up with key stakeholders
- Resolve high priority risks and issues
- Maintain program documents, reports, and supporting material
- Provide program status to partner teams and leadership
EDUCATION, TRAINING, AND PROFESSIONAL EXPERIENCE
- Bachelor’s degree (Required)
- Seven (7) or more years of experience in a health care or related field required
- Experience facilitating meetings and aligning resources to ensure projects and programs stay on-scope, on-schedule, and on-budget required
- Strong documentation skills required
- Experience in estimating, planning, and executing large scale, time sensitive initiatives in a matrixed environment required
- Familiarity with analytics and reporting tools such as SQL, Tableau and/or PowerBI required
- Advanced proficiency with Microsoft Excel, Power Point and Visio required
- Experience with actuarial and healthcare financial concepts, clinical cost, medical loss, and utilization metrics required
- Experience in and/or certification in a project management and/or performance improvement methodology (6 Sigma Black or Green Belt, Lean, PDSA, Scrum, etc.) is preferred
- Previous health plan experience, preferably in one of more of the following areas: finance, analytics, medical cost management
- Strong collaboration skills to work with internal teams to effectively identify and manage implementation of new solutions that achieve the targeted medical cost goals
- Excellent written and verbal communication skills
- Ability to perform multiple tasks and prioritize simultaneously
- Ability to perform critical analysis of complex problems and propose appropriate solutions
- Advanced time management, project management, and analytical skills
- High attention to detail
- Demonstrated flexibility, organization, and self-motivation
- Adaptable to change
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.